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"LI  B  RAHY 

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1892. 


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PSYCHOPATHIA  SeXUALIS, 


WITH  ESPECIAL  REFERENCE  TO 


Contrary  Sexual  Instinct: 


A  MEDICO-LEGAL  STUDY. 


By    3Dr.     B.    von    KRAFFT-EBING, 

Professor  of  Psychiatry  and  Neurology,  Univorsity  of  Vienna. 


AUTHORIZED  TRANSLATION 

OF  THE 

SEVENTH  ENLARGED  AND  REVISED  GERMAN  EDITION, 


CHARLES  GILBERT  CHADDOCK,  M.D., 

Profewior  of  Nervous  and  Mental  Diseases,  Marion-Sims  College  of  Medicine,  St.  Louis ;  Follow  of  the  Chicago  Acadomy 

of  Medicine ;  Corresponding  Member  of  the  Detroit  Academy  of  Medicine;  Associate 

Member  of  the  American  Medico-Psychological  Association,  etc. 


PHILADELPHIA  AND  LONDON  : 

THE  F.  A.  DAVIS  CO.,  PUBLISHERS. 

1893. 


Entered  according  to  Act  of  Congress,  in  the  year  1892,  by 

THE  F.  A.  DAVIS  COMPANY, 

In  the  Office  of  the  Librarian  of  Congress,  at  Washington,  D.  C,  TJ.  S.  A. 

All  rights  reserved. 


Philadelphia,  Pa.,  U.  8.  A.: 

The  Medical  Bulletin  Printing  House, 

1916  Cherry  Street. 


PREFACE  TO  THE  FIRST  EDITION. 


Very  few  ever  fully  appreciate  the  powerful  influence  which 
sexuality  exercises  over  feeling,  thought,  and  conduct,  both  in 
the  individual  and  in  society.  Schiller,  in  his  poem,  "  Die  Welt- 
weisen,"  recognizes  it  with  the  words : — 

"  Einstweilen  bis  den  Bau  der  Welt 
Philosophde  zusammenhalt, 
Erhalt  sie  das  Getriebe 
Durch  Hunger  und  durch  Liebe."1 

It  is  remarkable  that  the  sexual  life  has  received  but  a 
very  subordinate  consideration  on  the  part  of  philosophers. 

Schopenhauer  ("  The  World  as  Will  and  Idea  ")  thought 
it  strange  that  love  had  been  thus  far  a  subject  for  the  poet 
alone,  and  that,  with  the  exception  of  superficial  treatment  by 
Plato,  Rousseau,  and  Kant,  it  had  been  foreign  to  philosophers. 

What  Schopenhauer  and,  after  him,  the  Philosopher  of  the 
Unconscious,  E.  v.  Hartmann,  philosophized  concerning  the  sex- 
ual relations  is  so  imperfect,  and  in  its  consequences  so  distaste- 
ful, that,  aside  from  the  treatment  in  the  works  of  Michelet 
("  L'amour  ")  and  Mantegazza  ("  Physiology  of  Love  "),  which 
are  to  be  considered  more  as  brilliant  discussions  than  as  scien- 
tific treatises,  the  empirical  psychology  and  metaphysics  of  the 
sexual  side  of  human  existence  rest  upon  a  foundation  which  is 
scientifically  almost  puerile. 

The  poets  may  be  better  psychologists  than  the  psychol- 
ogists and  philosophers;  but  they  are  men  of  feeling  rather  than 
of  understanding,  and  at  least  one-sided  in  their  consideration  of 
the  subject.  They  cannot  see  the  deep  shadow  behind  the  light 
and  sunny  warmth  of  that  from  which  they  draw  their  inspira- 
tion. The  poetry  of  all  times  and  nations  would  furnish  inex- 
haustible material  for  a  monograph  on  the  psychology  of  love ; 
but  the  great  problem  can  be  solved  only  with  the  help  of 

1  "  Meanwhile,  until  Philosophy  shall  at  last  unite  and  maintain  the  world,  Hunger 
and  Love  impel  it  onward." 

(in) 


iv  PREFACE  TO   THE  FIRST  EDITION. 

Science,  and  especially  with  the  aid  of  Medicine,  which  studies 
the  psychological  subject  at  its  anatomical  and  physiological 
source,  and  views  it  from  all  sides. 

Perhaps  it  will  be  possible  for  medical  science  to  gain  a 
stand-point  of  philosophical  knowledge  midway  between  the 
despairing  views  of  philosophers  like  Schopenhauer  and  Hart- 
mann l  and  the  gay,  naive  views  of  the  poets. 

It  is  not  the  intention  of  the  author  to  lay  the  foundation 
of  a  psychology  of  the  sexual  life,  though  without  doubt  psycho- 
pathology  would  furnish  many  important  sources  of  knowledge 
to  psychology. 

The  purpose  of  this  treatise  is  a  description  of  the  patho- 
logical manifestations  of  the  sexual  life  and  an  attempt  to 
refer  them  to  their  underlying  conditions.  The  task  is  a  diffi- 
cult one,  and,  in  spite  of  years  of  experience  as  alienist  and 
medical  jurist,  I  am  well  aware  that  what  I  can  offer  must  be 
incomplete. 

The  importance  of  the  subject  for  the  welfare  of  society, 
especially  forensically,  demands,  however,  that  it  should  be  ex- 
amined scientifically.  Only  he  who,  as  a  medico-legal  expert, 
has  been  in  a  position  where  he  has  been  compelled  to  pass 
judgment  upon  his  fellow-men,  where  life,  freedom,  and  honor 
were  at  stake,  and  realized  painfully  the  incompleteness  of  our 
knowledge  concerning  the  pathology  of  the  sexual  life,  can 
fully  understand  the  significance  of  an  attempt  to  gain  definite 
views  concerning  it. 

Even  at  the  present  time,  in  the  domain  of  sexual  crimi- 
nality, the  most  erroneous  opinions  are  expressed  and  the  most 
unjust  sentences  pronounced,  influencing  laws  and  public  opinion. 

He  who  makes  the  psychopathology  of  sexual  life  the 
object  of  scientific  study  sees  himself  placed  on  a  dark  side  of 
human  life  and  misery,  in  the  shadows  of  which  the  god-like 

1  Hartmann's  philosophical  view  of  love,  in  the  "  Philosophy  of  the  Unconscious," 
p.  583,  Berlin,  18G9,  is  the  following  :  "  Love  causes  more  pain  than  pleasure.  Pleasure  is 
illusory.  Reason  would  cause  love  to  be  avoided  if  it  were  not  for  the  fatal  sexual  instinct ; 
therefore,  it  would  be  best  for  a  man  to  have  himself  castrated."  The  same  opinion,  minus 
the  consequence,  is  also  expressed  by  Schopenhauer  ("  Die  Welt  als  Wille  und  Vorstellung," 
8.  Aufl.,  Bd.  ii,  p.  686  u.  ff.). 


PREFACE  TO   THE   FIRST   EDITION".  V 

Creations  of  the  poet  become  hideous  masks,  and  morals  and 
aesthetics  seem  out  of  place  in  the  "  image  of  God." 

It  is  the  sad  province  of  Medicine,  and  especially  of  Psy- 
chiatry, to  constantly  regard  the  reverse  side  of  life, — human 
weakness  and  misery. 

Perhaps  in  this  difficult  calling  some  consolation  may  be 
gained,  and  extended  to  the  moralist,  if  it  be  possible  to  refer 
to  morbid  conditions  much  that  offends  ethical  and  aesthetic 
feeling.  Thus  Medicine  undertakes  to  save  the  honor  of  man- 
kind before  the  Court  of  Morality,  and  individuals  from  judges 
and  their  fellow-men.  The  duty  and  right  of  medical  science 
in  these  studies  belong  to  it  by  reason  of  the  high  aim  of  all 
human  inquiry  after  truth. 

The  author  would  take  to  himself  the  words  of  Tardieu 
("  Des  attentats  aux  moeurs"):  "Aucune  misere  physique  ou 
morale,  aucune  plaie,  quelque  corrompue  qu'elle  soit,  ne  doit 
effrayer  celui  qui  s'est  voue  a  la  science  de  Hiomme  et  le  min- 
istere  sacre  du  medecin,  en  l'obligeant  a  tout  voir,  lui  permet 
aussi  de  tout  dire."  * 

The  following  pages  are  addressed  to  earnest  investigators 
in  the  domain  of  natural  science  and  jurisprudence.  In  order 
that  unqualified  persons  should  not  become  readers,  the  author 
saw  himself  compelled  to  choose  a  title  understood  only  by  the 
learned,  and  also,  where  possible,  to  express  himself  in  terminis 
teclinicis.  It  seemed  necessary  also  to  give  certain  particularly 
revolting  portions  in  Latin 2  rather  than  in  German. 

It  is  hoped  that  this  attempt  to  present  to  physician  and 
jurist  facts  from  an  important  sphere  of  life  will  receive  kindly 
acceptance  and  fill  an  actual  hiatus  in  literature;  for,  with  the 
exception  of  certain  single  descriptions  and  cases,  the  literature 
presents  only  the  writings  of  Moreau  and  Tarnowsky,  which 
cover  but  a  portion  of  the  field.3 

1  "No  physical  or  moral  misery,  no  suffering,  however  corrupt  it  may  be,  should 
frighten  him  who  has  devoted  himself  to  a  knowledge  of  man  and  the  sacred  ministry  of 
medicine ;  in  that  he  Is  obliged  to  see  all  things,  let  him  be  permitted  to  say  all  things." 

2  The  Latin  is  left  untranslated. 

8  The  works  of  Moll  and  von  Schrenck-Notzing  have  since  appeared. — Trans. 


TRANSLATOR'S  PREFACE. 


The  distinguished  author  of  "  Psychopathia  Sexualis" 
speaks  for  himself  and  his  work  in  its  preface ;  but  there  are 
not  wanting  others  to  speak  for  him. 

Dr.  A.  von  Schrenck-Notzing,  of  Munich,  writes l : — 

"  It  may  be  questioned  whether  it  is  justifiable  to  discuss 
the  anomalies  of  the  sexual  instinct  apart,  instead  of  treating 
of  them  in  their  proper  place  in  psychiatry.  As  a  rule,  they 
are  certainly  only  symptoms  of  a  constitutional  malady,  or  of  a 
weakened  state  of  the  brain,  which  manifest  themselves  in  the 
various  forms  of  sexual  perversion. 

"  Moreover,  attention  has  been  directed  to  the  baneful  influ- 
ence possibly  exerted  by  such  publications  as  '  Psychopathia 
Sexualis.'  To  be  sure,  the  appearance  of  seven  editions  of 
that  work  could  not  be  accounted  for  were  its  circulation  con- 
fined to  scientific  readers.  Therefore,  it  cannot  be  denied  that 
a  pornographic  interest  on  the  part  of  the  public  is  accountable 
for  a  part  of  the  wide  circulation  of  the  book.  But,  in  spite  of 
this  disadvantage,  the  injury  done  by  implanting  knowledge  of 
sexual  pathology  in  unqualified  persons  is  not  to  be  compared 
with  the  good  accomplished.  History  shows  that  uranism  was 
very  wide-spread  long  before  the  appearance  of  '  Psychopathia 
Sexualis.'  The  courts  have  constantly  to  deal  with  sexual 
crimes  in  which  the  responsibility  of  the  accused  comes  in 
question. 

"For  the  physician  himself,  sexual  anomalies,  treated  as 
they  are  in  a  distant  manner  in  text-books  on  psychiatry,  are 
in  greater  part  a  terra  incognita.  Exact  knowledge  of  the 
causes  and  conditions  of  development  of  sexual  aberrations, 

• , 

1  Die'Suggestions-Therapie,  etc.,  F.  Enke,  Stuttgart,  1892. 

(Vii) 


viii  .  translator's  PREFACE!. 

and  of  the  influence  on  them  of  hereditary  constitution,  educa- 
tion, the  impressions  of  every-day  life,  and  modern  refined  civil- 
ization, is  the  prerequisite  for  a  rational  prophylaxis  of  sexual 
aberrations,  and  for  a  correct  sexual  education.  Without  care- 
ful study  of  the  circumstances  which  attend  the  development  of 
sexual  anomalies,  we  should  never  be  in  a  position  to  use  effect- 
ual  therapeusis.  The  majority  of  these  unfortunates — KrafFt- 
Ebing  calls  them  Nature's  step-children — are  devoid  of  insight 
into  their  malady ;  like  insane  patients  destitute  of  understand- 
ing of  the  ethical  development  of  man,  they  are  happy  in  their 
abnormal  instinctive  tendency.  For  this  reason,  in  spite  of  the 
great  prevalence  of  uranism,  yery  few  of  its  subjects  seek  med- 
ical treatment.  While  the  terminal  forms  of  sexual  aberrations 
end  in  asylums  for  the  insane,  the  doubtful  cases,  in  which 
incompleteness  of  development  or  apparent  viciousness  render 
correct  diagnosis  difficult,  make  up  the  majority.  But  a  thorough 
knowledge  of  the  aberrations  of  the  sexual  instinct  is  absolutely 
indispensable  to  the  jurist.  The  reasons  given  are  thus  suffi- 
ciently important  to  demonstrate  the  need  of  a  hand-book  on 
'  psychopathia  sexualis.' " 

These  words  also  hold  true  for  English-speaking  physicians 
and  jurists, — who  can  scarcely  fail  to  welcome  the  translation 
of  a  work  so  systematic  and  comprehensive  as  "  Psychopathia 
Sexualis " ;  a  work  conceived  and  executed  in  the  highest  scien- 
tific and  humane  spirit ;  a  work  which  not  only  broadens  and 
■ey&tCTIlatlzes  our  knowledge  of  psycho-sexual  phenomena,  but  also 
demonstrates,  in  the  results  of  hypnotic  suggestion,  how  impor- 
tant mental  therapeusis  must  ultimately  become  in  the  hands  of 
the  physician;  a  work  which  is  a  trustworthy  guide  in  the 
study  of  the  concrete  case  of  sexual  crime,  and  a  philosophical 
treatise  on  the  inter-relations  of  sexual  criminality,  disease,  and 
criminal  anthropology. 

The  difficulties  of  translation  have  not  been  slight;  but 
minor  errors  cannot  destroy  the  author's  meaning. 

For  much  encouragement  in  the  work  of  translation  my 
gratitude  to  Dr.  James  G.  Kiernan  and  Dr.  G.  Frank  Lydston, 
of  Chicago,  both  well-known  investigators  in  this  domain  of 


translator's  preface.  ix 

psychopathology,  is  here  expressed ;  and  to  Dr.  William  A. 
Stone,  Assistant  Superintendent  at  the  Michigan  Asylum,  Kal- 
amazoo, I  am  greatly  indebted  for  assistance  in  the  preparation 
of  the  manuscript. 


Charles  Gilbert  Chaddock. 


St.  Louts,  Mo., 

November,  1892. 


TABLE  OF  CONTENTS. 


PACK 

I.  Fragment  of  a  Psychology  op  the  Sexual  Life,   ...  1 

Power  of   the  sexual  instinct, 1 

Sexuality  as  the  foundation  of  ethical  feeling,  ....  1 

Love  as  a  passion, 2 

History  of  development  of  sexuality, 2 

Modesty, 2 

Christianity, 4 

Monogamy, 4 

Woman's  place  in  Islam, 5 

Sensuality  and  morality, 5 

Decadence  of  sexual  morality, G 

Development  of  sexual  feelings  in  the  individual ;  puberty,      .  7 

Sensuality  and  religious  enthusiasm,          .         .         .        .        .  9 

Relations  between  the  spheres  of  religion  and  sexuality, .        .  9 

Sensuality  and  art, 10 

Idealizing  tendency  of  first  love, 11 

True  love, 11 

Sentimentality, 11 

Platonic  love, 12 

Love  and  friendship, 12 

Difference  between  male  and  female  love, 13 

Celibacy, 14 

Unfaithfulness, 15 

Marriage, 15 

Desire  for  adornment, 16 

Facts  of  physiological  fetichism, 17 

Religious  and  erotic  fetichism, 17 

Eyes,  odors,  voices,  and  mental  qualities  as  fetiches,         .        .  21 

Hair,  hand,  and  foot  of  woman  as  fetiches,        ....  22 

II.  Physiology, 23 

Sexual  maturity,         .         . 23 

Duration  of  sexual  instinct, 23 

(xi) 


xii  TABLE   OF   CONTENTS. 

PAGE 

Sexual  sense, 24 

Localization  (?), 24 

Physiological  development  of  sexuality, 24 

Erection  ;  erection-centre, 24 

Sexuality  and  the  olfactory  sense,      .         .         .         .         .         .26 

Flagellation  an  excitant  of  sexual  desire, 28 

Sects  of  flagellants, ,28 

Paullini's  "  Flagellum  Salutis," 29 

Erogenous  zones, 31 

Control  of  the  sexual  instinct, 32 

Cohabitation, 32 

Ejaculation, 33 

III.  General  Pathology,        .        .        .        .        .        .        .        .34 

Frequency  and  importance  of  pathological  manifestations,       .       34 
Schema  of  the  sexual  neuroses,  .         .         .         .         .         .34 

Spinal  neuroses,  .         . 35 

Cerebral  neuroses, •    .       36 

Paradoxia  sexualis, 37 

Anaesthesia  sexualis  (congenital), .42 

Anaesthesia  sexualis  (acquired), 47 

Hyperaesthesia  sexualis, 48 

Paraesthesia  sexualis, 56 

Perversion  and  perversity, 56 

Sadism, 57 

.    An  attempt  to  explain  sadism, 57 

Sadistic  lust-murder, 62 

Anthropophagy, 64 

Violation  of  corpses, 67 

Injury  of  women, 70 

Defilement  of  women, 79 

Symbolic  sadism, 81 

Sadism  with  any  object, 82 

Whipping  of  boys, 82 

Sadistic  acts  with  animals, '  .84 

Sadism  in  woman, 87 

Mosochism, 89 

Relation  of  passive  flagellation  to  masochism, .         .         .         .101 


TABLE   OF   CONTENTS.  Xlll 

PAGK 

Ideal  masochism,         .         .         . 115 

Symbolic  masochism, 116 

Rousseau, 119 

Larvated  masochism, 123 

Feminine  masochism, .         .         .         .         .    .     .         .         .        .  137 

An  attempt  to  explain  masochism, 139 

Masochism  and  sadism, 148 

Fetichism, 152 

Part  of  the  female  body  as  a  fetich,   ......  157 

Female  attire  as  a  fetich,    .         . 167 

Special  materials  as  fetiches, 180 

Contrary  sexual  instinct,  or  homo-sexuality,     .         .         .         .185 

Acquired  homo-sexuality, 188 

Simple  reversal  of  sexual  feeling, 191 

Eviration  and  defemination, 197 

Transition  to  metamorphosis  sexualis  paranoica,       .         .         .  202 

Metamorphosis  sexualis  paranoica, 216 

Congenital  homo-sexuality, 222 

Psychical  hermaphroditism, 230 

Urnings, 255 

E Semination  and  viraginity, ;      .  279 

Androgyny  and  gynandry, 304 

Diagnosis,  prognosis,  and  therapy  of  contrary  sexuality,  .  319 

IV.  Special  Pathology, 358 

Pathological  sexuality  in  the  various  forms  of  mental  dis- 
ease,            .        .  358 

Imbecility, 359 

Dementia, 361 

Paretic  dementia, 363 

Epilepsy, 364 

Periodical  insanity, 370 

Psychopathia  sexualis  periodica, 371 

Mania, 372 

Satyriasis  and  nymphomania, 373 

Melancholia, 374 

Hysteria, 375 

Paranoia,    .         .         .         . 376 


XIV  TABLE   OF   CONTENTS. 

PAGB 

V.  Pathological  Sexuality  in  its  Legal  Aspects,     .        .        .  378 

Dangers  to  society  from  sexual  crimes, 378 

Increase  of  sexual  crimes, .378 

Causes, 378 

Defective  appreciation  of  such  crimes  by  jurists,      .         .         .379 

Conditions  necessary  to  remove  legal  responsibility,         .        .  381 

Exhibition, 382 

Violation  of  statues, 396 

Rape  and  lust-murder, 397 

Bodily  injury,  injury  to  property,  and  torture  of  animals  de- 
pendent on  sadism, 401 

Fetichism, 401 

Violation  of  children, 402 

Sodomy, 404 

Pederasty, 408 

Cultivated  pederasty, 414 

Social  life  of  pederasts, 415 

Ball  of  the  woman-haters, 417 

Paedicatio  mulierum, 420 

Lesbian  love, 428 

Necrophilia, .  430 

Incest, 431 

Immoral  acts  with  persons  in  the  care  of  others,       .         .         .  432 


I.   A  FRAGMENT 

OF  A 

PSYCHOLOGY  OF  THE  SEXUAL  LIFE. 


The  propagation  of  the  human  species  is  not  committed 
to  accident  or  to  the  caprice  of  the  individual,  but  made  secure 
in  a  natural  instinct,  which,  with  all-conquering  force  and 
might,  demands  fulfillment.  In  the  gratification  of  this  natural 
impulse  are  found  not  only  sensual  pleasure  and  sources  of 
physical  well-being,  but  also  higher  feelings  of  satisfaction  in 
perpetuating  the  single,  perishable  existence,  by  the  transmission 
of  mental  and  physical  attributes  to  a  new  being.  In  coarse, 
sensual  love,  in  the  lustful  impulse  to  satisfy  this  natural  instinct, 
man  stands  on  a  level  with  the  animal ;  but  it  is  given  to  him 
to  raise  himself  to  a  height  where  this  natural  instinct  no 
longer  makes  him  a  slave :  higher,  nobler  feelings  are  awakened, 
which,  notwithstanding  their  sensual  origin,  expand  into  a 
world  of  beauty,  sublimity,  and  morality. 

On  this  height  man  overcomes  his  natural  instinct,  and 
from  an  inexhaustible  spring  draws  material  and  inspiration 
for  higher  enjoyment,  for  more  earnest  work,  and  the  attainment 
of  the  ideal.  Maudsley  (Deutsche  Klinik,  1873,  2,  3)  rightly 
calls  the  sexual  feeling  the  foundation  for  the  development  of 
the  social  feeling.  "  Were  man  to  be  robbed  of  the  instinct 
of  procreation  and  all  that  arises  from  it  mentally,  nearly  all 
poetry  and,  perhaps,  the  entire  moral  sense  as  well,  would  be 
torn  from  his  life." 

Sexuality  is  the  most  powerful  factor  in  individual  and 
social  existence;  the  strongest  incentive  to  the  exertion  of 
strength  and  acquisition  of  property,  to  the  foundation  of  a 
home,  and  to  the  awakening  of  altruistic  feelings,  first  for  a 
person  of  the  opposite  sex,  then  for  the  offspring,  and,  in  a 
wider  sense,  for  all  humanity. 

(i) 


2  PSYCHOPATHIA    SEXUALIS. 

Thus  all  ethics  and,  perhaps,  a  good  part  of  aesthetics 
and  religion  depend  upon  the  existence  of  sexual  feeling. 

Though  the  sexual  life  leads  to  the  highest  virtues,  even  to 
the  sacrifice  of  the  ego,  yet  in  its  sensual  force  lies  also  the.danger 
that  it  may  degenerate  into  powerful  passions  and  develop  the 
grossest  vices. 

Love  as  an  unbridled  passion  is  like  a  fire  that  burns 
and  consumes  everything;  like  an  abyss  that  swallows  all, — 
honor,  fortune,  well-being. 

It  seems  of  high  psychological  interest  to  trace  the  devel- 
opmental phases  through  which,  in  the  course  of  the  evolution 
of  human  culture  to  the  morality  and  civilization  of  to-day,  the 
sexual  life  has  passed.1  On  primitive  ground  the  satisfaction 
of  the  sexual  appetite  of  man  seems  like  that  of  the  animal. 
Openness  in  the  sexual  act  is  not  shunned ;  man  and  woman 
are  not  ashamed  to  go  naked.  To-day  we  see  savages  in  this 
condition  (comp.  Ploss,  "Das  Weib,"  p.  196,  1884);  as,  for 
example,  the  Australians,  the  Polynesians,  and  the  Malays  of 
the  Phillipines.  The  female  is  the  common  property  of  the 
males,  the  temporary  booty  of  the  strongest,  who  strive  for  the 
possession  of  the  most  beautiful  of  the  opposite  sex,  thus  carry- 
ing out  instinctively  a  kind  of  sexual  selection. 

Woman  is  a  movable  thing,  a  ware,  an  object  of  bargain 
and  sale  and  gift ;  a  thing  to  satisfy  lust  and  to  work. 

The  appearance  of  a  feeling  of  shame  before  others  in 
the  manifestation  and  satisfaction  of  the  natural  instinct,  and 
modesty  in  the  intercourse  of  the  sexes,  form  the  beginning  of 
morality  in  the  sexual  life.  From  this  arose  the  effort  to  con- 
ceal the  genitals  ("And  they  knew  that  they  were  naked") 
and  the  secret  performance  of  the  sexual  act. 

The  development  of  this  degree  of  culture  is  favored  by 
the  rigors  of  climate  and  the  necessity  for  complete  protection 
of  the  body  thus  entailed.  Thus  in  part  the  fact  is  explained 
that  among  northern  races  modesty  may  be  proved  anthropo- 
logically earlier  than  among  southern  races. 

A  further  stage  in  the  development  of  culture  in  sexual 


1  Comp.  Lombroso,  "  The  Criminal." 


PSYCHOLOGY   OF   THE   SEXUAL   LIFE.  3 

life  is  marked  when  the  female  ceases  to  be  a  movable  thing. 
She  becomes  a  person ;  and  if  still  for  a  long  time  placed  far 
below  the  male  socially,  yet  the  idea  that  the  right  of  disposal 
of  herself  and  her  favors  belongs  to  her  is  developed. 

Thus  she  becomes  the  object  of  the  male's  wooing.  To 
the  barbarous  sensual  feeling  of  sexual  desire  the  beginnings  of 
ethical  feeling  are  added.  The  instinct  is  intellectualized.  Prop- 
erty in  women  ceases  to  exist.  Individuals  of  the  opposite  sexes 
feel  themselves  drawn  toward  each  other  by  mental  and  physi- 
cal qualities,  and  show  love  for  each  other  only.  At  this  stage 
woman  has  a  feeling  that  her  charms  belong  only  to  the  man 
of  her  choice,  and  wishes  to  conceal  them  from  others.  Thus, 
by  the  side  of  modesty,  the  foundations  of  chastity  and  faith- 
fulness— as  long  as  the  bond  of  love  lasts — are  laid. 

Woman  attains  this  degree  of  social  elevation  earlier 
when,  at  the  transition  from  nomadic  life  to  a  state  of  fixed 
habitation,  man  obtains  a  house  and  home,  and  the  necessity 
arises  for  him  to  possess  in  woman  a  companion  for  the  house- 
hold,— a  housewife. 

Among  the  nations  of  the  East,  the  Egyptians,  the  Israelites, 
and  the  Greeks,  and  among  those  of  the  West,  the  Germans, 
early  attained  this  stage  of  culture.  Among  all  these  races,  at 
this  stage  of  advancement,  the  esteem  in  which  virginity, 
chastity,  modesty,  and  sexual  faithfulness  are  held  is  in  marked 
contrast  with  other  nations  which  offer  the  female  of  the  house 
to  the  guest  for  his  sexual  enjoyment.1 

That  this  stage  in  the  culture  of  sexual  morality  is  quite 
high  and  makes  its  appearance  much  later  than  other  develop- 
mental forms  of  culture — as,  for  example,  aesthetics — is  seen 
from  the  condition  of  the  Japanese,  with  whom  it  is  the  custom 
to  marry  a  woman  only  after  she  has  lived  for  a  year  in  the 
tea-houses  (which  correspond  with  European  houses  of  prosti- 
tution), and  to  whom  the  nakedness  of  women  is  nothing  shock- 
ing. At  all  events,  among  the  Japanese  every  unmarried  woman 
can  prostitute  herself  without  lessening  her  value  as  a  future 
wife5 — a  proof  that  with  this  remarkable  people  woman  possesses 

i  Comp.  Westermarck,  "  History  of  Human  Marriage."    McMillan  &  Co.,  1891. 


4  -    PSYCHOPATHIA   SEXUALIS. 

no  ethical  worth,  but  is  valued  in  marriage  only  as  a  means  of 
enjoyment,  procreation,  and  work. 

Christianity  gave  the  most  powerful  impulse  to  the  moral 
elevation  of  the  sexual  relations  by  raising  woman  to  social 
equality  with  man  and  elevating  the  bond  of  love  between 
man  and  woman  to  a  religio-moral  institution.1 

The  fact  that  in  higher  civilization  human  love  must  be 
monogamous  and  rest  on  a  lasting  contract  was  thus  recognized. 
If  nature  does  no  more  than  provide  for  procreation,  a  common- 
wealth (family  or  state)  cannot  exist  without  a  guaranty  that 
the  offspring  shall  flourish  physically,  morally,  and  intellectually. 
Christendom  gained  both  mental  and  material  superiority  over 

1  This  generally  entertained  idea,  also  held  by  many  historians,  requires  some  limita- 
tion, in  that  the  symbolic  and  sacramental  character  of  marriage  was  first  made  clear  and 
unequivocal  by  the  Council  of  Trent,  even  though  there  was  ever  in  the  spirit  of  Christianity 
that  which  would  free  woman  and  raise  her  from  the  inferior  position  occupied  by  her  in  the 
ancient  world  and  the  Old  Testament. 

That  this  took  place  so  late  may  well  be  due  in  part  to  the  traditions  of  Genesis  of 
the  secondary  creation  of  woman  from  the  rib  of  man,  and  of  her  part  in  the  Fall,  and  the 
consequent  curse  :  "  Thy  will  shall  be  to  thy  husband."  Since  the  Fall,  for  which  the  Old 
Testament  made  woman  responsible,  became  the  corner-stone  of  the  fabric  of  church- 
teachings,  the  wife's  social  position  could  but  remain  inferior  until  the  spirit  of  Christianity 
had  gained  a  victory  over  tradition  and  scholasticism. 

It  is  remarkable  that,  with  the  exception  of  the  interdiction  of  putting  away  a 
wife  (Matt,  xix,  9),  the  gospels  contain  nothing  favoring  woman.  Gentleness  toward  the 
adulteress  and  the  repentant  Magdalene  does  not  affect  the  position  of  the. wife  in  itself. 
The  Epistles  of  Paul  specifically  declare  that  the  position  of  woman  shall  not  be  altered 
(II  Corinth,  xi,  3-12  ;  Ephes.  v,  22  :  "  Wives,  submit  yourselves  unto  your  husbands ;"  and 
33,  "  And  the  wife  see  that  6he  reverence  her  husband  "). 

Passages  in  Tertullian  show  how  the  Fathers  of  the  Church  were  prejudiced  against 
woman  by  Eve's  guilt :  "  Woman,  thou  shouldst  forever  go  in  sorrow  and  rags,  thy  eyes 
filled  with  tears  !  Thou  hast  brought  man  to  the  ground  !"  St.  Hieronymus  has  nothing 
good  to  say  of  woman.  He  says,  "  Woman  is  a  door  for  the  devil,  a  way  to  evil,  the  sting 
of  the  scorpion."     ("  De  cultu  feminarum,"  i,  1.) 

Canonical  Law  declares  :  "  Only  man  was  created  in  the  image  of  God,  not  woman ; 
therefore,  woman  should  serve  him  and  be  his  maid  !" 

The  Provincial  Council  of  Macon,  in  the  sixth  century,  earnestly  debated  the  ques- 
tion whether  woman  had  a  soul. 

The  effect  of  these  ideas  in  the  Church  on  the  peoples  embracing  Christianity  was 
direct.  Among  the  Germans,  after  the  acceptance  of  the  new  faith,  for  the  foregoing  reason, 
the  weregild  for  a  wife — the  simple  expression  of  her  value — decreased  (J.  Falke,  "  Die 
ritterliche  Gesellschaft,"  p.  49.  Berlin,  1862).  Concerning  the  value  of  each  sex  among 
the  Jews,  vide  Leviticus,  xxvii,  3  and  4. 

Moreover,  polygamy,  which  is  expressly  recognized  in  the  Old  Testament  (Deut.  xxi, 
15),  is  nowhere  explicitly  interdicted  in  the  New  Testament.  Christian  princes  {e.g.,  the 
Marovingian  kings,  Clotar  I,  Childebert  I,  Pepin  I,  and  many  of  the  royal  Franks)  lived  in 
polygamy;  and  at  that  time  the  Church  made  no  opposition  to  it  (Weinhold,  "  Die  deut- 
schen  Frauen  im  Mittelalter,"  ii,  p.  15).  Comp.  alsoUnger,  "  Die  Ehe,"  etc.,  and  the  excel- 
lent work  by  Louis  Bridel,  "  La  femme  et  le  droit,"  Paris,  1884. 


PSYCHOLOGY   OF   THE   SEXUAL  LIFE.  5 

the  polygamous  races,  especially  Islam,  through  the  equalization 
of  woman  and  man,  and  by  establishing  monogamous  marriage 
and  securing  it  by  legal,  religious,  and  moral  ties. 

If  Mohammed  was  actuated  by  a  desire  to  raise  woman 
from  her  place  as  a  slave  and  means  of  sensual  gratification  to 
a  higher  social  and  matrimonial  plane,  nevertheless,  in  the 
Mohammedan  world  woman  remained  far  below  man,  to  whom 
alone  divorce  was  allowed  and  also  made  very  easy. 

Islam  kept  woman  from  any  participation  in  public  life 
under  all  circumstances,  and  thus  hindered  her  intellectual  and 
moral  development.  In  consequence  of  this  the  Mohammedan 
woman  has  ever  remained  essentially  a  means  of  sensual  gratifi- 
cation and  procreation ;  while,  on  the  other  hand,  the  virtues 
and  capabilities  of  the  Christian  woman,  as  housewife,  educator 
of  children,  and  equal  companion  of  man,  have  been  allowed 
to  unfold  in  all  their  beauty.  Islam,  with  its  polygamy  and 
harem-life,  is  glaringly  contrasted  with  the  monogamy  and 
family  life  of  the  Christian  world. 

The  same  contrast  is  apparent  in  a  comparison  of  the  two 
religions  with  reference  to  the  conception  of  the  hereafter.  The 
picture  of  eternity  seen  by  the  faith  of  the  Christian  is  that  of  a 
paradise  freed  from  all  earthly  sensuality,  promising  the  purest 
of  intellectual  happiness ;  the  fancy  of  the  Mussulman  fills  the 
future  life  with  the  delights  of  a  harem  full  of  houris. 

In  spite  of  all  the  aids  which  religion,  law,  education,  and 
morality  give  civilized  man  in  the  bridling  of  his  passions,  he  is 
always  in  danger  of  sinking  from  the  clear  height  of  pure,  chaste 
love  into  the  mire  of  common  sensuality. 

In  order  to  maintain  .one's  self  on  such  a  height,  a  con- 
stant struggle  between  natural  impulses  and  morals,  between 
sensuality  and  morality,  is  required.  Only  characters  endowed 
with  strong  wills  are  able  to  completely  emancipate  themselves 
from  sensuality  and  share  in  that  pure  love  from  which  spring 
the  noblest  joys  of  human  life. 

It  is  yet  questionable  whether,  in  the  course  of  the  later 
centuries,  mankind  has  advanced  in  morality.  It  is  certain, 
however,  that  the  race  has  become  more  modest ;  and  this  phe- 


6  .  PSYCHOPATHIA   SEXUALlS. 

nomenon  of  civilization — this  hiding  of  the  animal  propensities 
is,  at  least,  a  concession  that  vice  makes  to  virtue. 

From  a  reading  of  Scherr's  works  ("  History  of  German 
Civilization  ")  one  would  certainly  gain  the  impression  that,  in 
comparison  with  those  of  the  Middle  Ages,  our  own  ideas  of 
morals  have  become  refined,  even  when  it  must  also  be  allowed 
that  in  many  instances  finer  manners,  without  greater  morality, 
have  taken  the  place  of  earlier  obscenity  and  coarseness  of 
expression. 

When  widely  separated  periods  of  history  are  compared,  no 
doubt  is  left  that  public  morality,  in  spite  of  occasional  temporary 
retrogression,  makes  continuous  progress,  and  that  Christianity  is 
one  of  the  most  powerful  of  the  forces  favoring  moral  progress. 

To-day  we  are  far  beyond  the  sexual  conditions  which,  as 
shown  in  the  sodomitic  worship  of  the  gods,  in  the  life  of  the 
people,  and  in  the  laws  and  religious  practices,  existed  among  the 
ancient  Greeks, — to  say  nothing  of  the  worship  of  Phallus  and 
Priapus  among  the  Athenians  and  Babylonians,  of  the  bacchanals 
of  ancient  Rome,  and  the  prominent  place  prostitutes  took  among 
these  peoples.  In  the  slow  and  often  imperceptible  progress 
which  human  morality  makes  there  are  variations  or  fluctuations, 
just  as  in  the  individual  sexuality  manifests  an  ebb  and  flow. 

Periods  of  moral  decadence  in  the  life  of  a  people  are 
always  contemporaneous  with  times  of  effeminacy,  sensuality, 
and  luxury.  These  conditions  can  only  be  conceived  as  occur- 
ring with  increased  demands  upon  the  nervous  system,  which 
must  meet  these  requirements.  As  a  result  of  increase  of 
nervousness,  there  is  increase  of  sensuality,  and,  since  this  leads 
to  excesses  among  the  masses,  it  undermines  the  foundation  of 
society, — the  morality  and  purity  of  family  life.  When  this  is 
destroyed  by  excesses,  unfaithfulness,  and  luxury,  then  the  de- 
struction of  the  state  is  inevitably  compassed  in  material,  moral, 
and  political  ruin.  Warning  examples  of  this  character  are 
presented  by  Rome,  Greece,  and  France  under  Louis  XIV 
and  XV.1     In  such  times  of  political  and  moral  destruction 

1  Comp.  "  Friedlander  "  Sittengeschichte  Roms."  Wiedcmeister,  "  Der  Casaren- 
wahnsinn."    Suetonius.     Moreau,  "  Des  aberrations  du  sens  g6nesique." 


PSYCHOLOGY   OF   THE    SEXUAL   LIFE.  7 

monstrous  perversions  of  the  sexual  life  were  frequent,  which, 
however,  may  in  part  be  referred  to  psycho-pathological  or, 
at  least,  neuro-pathological  conditions  existing  in  the  people. 

It  is  shown  by  the  history  of  Babylon,  Nineveh,  Rome, 
and  also  by  the  "  mysteries  "  of  life  in  modern  Capitals,  that 
large  cities  are  the  breeding-places  of  nervousness  and  degen- 
erate sensuality.  The  fact  which  may  be  learned  from  reading 
Ploss's  work  is  remarkable,  viz.,  that  perversion  of  the  sexual 
instinct  (save  among  the  Aleutians,  and  in  the  form  of  mastur- 
bation among  the  females  of  the  East  and  the  Nama  Hottentots) 
does  not  occur  in  uncivilized  or  half-civilized  races.1 

The  study  of  the  sexual  life  in  the  individual  must  begin 
at  its  development  at  puberty,  and  follow  it  through  its  different 
phases  to  the  extinction  of  sexual  feelings.  In  his  "  Physiology 
of  Love,"  Mantegazza  describes  the  longings  and  impulses  of 
awakening  sexual  life,  of  which  presentiments,  indefinite  feel- 
ings, and  impulses  have  existed  long  before  the  epoch  of 
puberty.  This  epoch  is,  physiologically,  the  most  important. 
In  the  abundant  increase  of  feelings  and  ideas  which  it  en- 
genders is  manifested  the  significance  of  the  sexual  factor  in 
mental  life. 

These  impulses,  at  first  vague  and  incomprehensible,  arising 
from  the  sensations  which  are  awakened  by  organs  which  were 
previously  undeveloped,  are  accompanied  by  a  powerful  excita- 
tion of  the  emotions.  The  psychological  reaction  of  the  sexual 
impulse  at  puberty  expresses  itself  in  a  multitude  of  manifesta- 
tions which  have  in  common  only  the  mental  condition  of  emo- 
tion and  the  impulse  to  express  in  some  way,  or  render  objective, 
the  strange  emotionality.  Religion  and  poetry  lie  close  to  it, 
which,  after  the  time  of  sexual  development  is  .past  and  these 
originally  incomprehensible  feelings  and  impulses  have  cleared 
up,  receive  powerful  incentives  from  the  sexual  sphere.  He 
who  doubts  this  has  only  to  think  how  often  religious  enthusiasm 
occurs  at  the  time  of  puberty ;  how  frequent  sexual  episodes  are 


1  These  statements,  however,  are  opposed  to  Friedreich  ("Hdb.  d.  gerichtsarztl 
Praxis,"  i,  p.  271, 1843),  and  also  Lombroso  (op.  tit.,  p.  42),  according  to  whom  pederasty 
is  very  frequent  among  the  uncivilized  Americans. 


8  PSYCHOPATHIA   SEXtJALlS. 

in  the  lives  of  the  saints;1  how  powerfully  sensuality  expresses 
itself  in  the  histories  of  religious  fanatics ;  and  in  what  revolting 
scenes,  true  orgies,  the  religious  festivals  of  antiquity,  no  less 
than  the  "  meetings  "  of  certain  sects  in  modern  times,  express 
themselves, — to  say  nothing  of  the  lustful  mysteries  which  char- 
acterized the  cults  of  the  ancients.  On  the  other  hand,  we  see 
that  unsatisfied  sensuality  very  frequently  finds  an  equivalent  in 
religious  enthusiasm.2 

This  relation  between  religious  and  sexual  feeling  is  also 
shown  on  the  basis  of  unequivocal  psycho-pathological  states. 
It  suffices  to  recall  how  intense  sensuality  makes  itself  manifest 
in  the  clinical  histories  of  many  religious  maniacs ;  the  motley 
mixture  of  religious  and  sexual  delusions  that  is  so  frequently 
observed  in  psychoses  (e.g.,  in  maniacal  women,  who  think  they 
are  or  will  be  the  Mother  of  God),  but  particularly  in  mastur- 
batic  insanity ;  and,  finally,  the  sensual,  cruel  self-punishments, 
injuries,  self-castrations,  and  even  self-crucifixions  resulting  from 
abnormal  sexual-religious  feeling. 

Any  attempt  to  explain  the  relations  between  religion  and  love  has 
difficulties  to  encounter.  Many  analogies  present  themselves.  The  feeling 
of  sexual  attraction  and  religious  feeling  (considered  as  a  psychological 
fact)  consist  of  two  elements. 

In  religion  the  primary  element  is  a  feeling  of  dependence, — a  fact 
which  Schleiermacher  recognized  long  before  the  later  studies  in  anthro- 
pology and  ethnography,  founded  on  the  observation  of  primitive  condi- 
tions, had  led  to  the  same  conclusion.  It  is  only  at  a  higher  stage  of  cul- 
ture that  the  second  and  essentially  ethical  element — love  of  God — enters 

1Comp.  Friedreich,  "gerichtl.  Psychologie,"  p.  389,  who  has  collected  numerous 
examples.  Thus  the  nun  Blanbekin  was  always  troubled  with  the  thought  about  what  had 
become  of  the  part  lost  at  the  circumcision  of  Christ.  Veronica  Juliani,  canonized  by  Pope 
Pius  II,  in  memory  of  the  divine  lion,  took  an  actual  lion  in  her  bed  and  kissed  it,  and  let 
it  suck  from  her  breast ;  and  even  secreted  a  few  drops  of  milk  for  it.  St.  Catherine,  of 
Genoa,  often  burned  with  such  inward  Are  that,  in  order  to  cool  herself,  she  would  lie  down 
on  the  ground  and  cry  "  Love,  love,  I  can  endure  it  no  longer  !  "  At  the  same  time  she 
felt  a  peculiar  inclination  for  her  confessor.  One  day  she  lifted  his  hand  to  her  nose  and 
smelled  an  odor  which  penetrated  to  her  heart,  "  a  heavenly  perfume,  so  delightful  that  it 
would  wake  the  dead."  St.  Armelle  and  St.  Elizabeth  were  troubled  with  a  similar 
longing  for  the  child  Jesus.  The  temptations  of  St.  Anthony,  of  Padua,  are  well  known. 
An  old  prayer  is  significant:  "  O,  that  I  had  found  thee,  Holy  Emanuel ;  O,  that  I  had  thee 
in  my  bed  to  bring  delight  to  body  and  soul.  Come  and  be  mine,  and  my  heart  shall  be 
thy  resting-place." 

2  Comp.  Friedreich,  "  Diagnostik  der  psych.  Krankheiten,"  p.  247  u.ff.  ;  Neumann, 
"  Lehrb.  d.  Psychiatrie,"  p.  80. 


PSYCHOLOGY  OF  THE  SEXUAL  LIFE.  9 

into  religious  feeling.  In  the  place  of  the  evil  spirits  of  the  primitive 
peoples  came  the  two-faced — now  kind,  now  angry — creations  of  the  more 
complicated  mythologies,  until,  finally,  the  God  of  love,  as  the  giver  of 
eternal  happiness,  is  reverenced,  whether  this  be  hoped  for  from  Jehovah, 
as  a  blessing  on  earth ;  from  Allah,  as  a  physical  blessing  in  Paradise ; 
from  Christ,  as  eternal  bliss  in  heaven ;  or  as  the  Nirvana  of  the  Buddhists. 

In  sexual  desire,  love,  the  expectation  of  unbounded  happiness  is  the 
primary  element.  The  feeling  of  dependence  is  of  secondary  develop- 
ment. The  nucleus  of  this  feeling  exists  in  both  parties,  but  it  may  re- 
main undeveloped  in  one.  As  a  rule,  owing  to  her  passive  part  in 
procreation  and  social  conditions,  it  is  more  pronounced  in  woman ;  but 
exceptionally  this  is  true  of  men  having  minds  that  approach  the  feminine 
type. 

In  both  the  religious  and  sexual  spheres  love  is  mystical,  trans- 
cendental. In  sexual  love  the  real  purpose  of  the  instinct,  the  propaga- 
tion of  the  species,  does  not  enter  into  consciousness ;  and  the  strength 
of  the  desire  is  greater  than  any  that  consciousness  of  purpose  could 
create.  In  religion,  however,  the  good  sought  and  the  object  of  devotion 
are  of  such  nature  that  they  cannot  become  a  part  of  empirical  knowledge. 
Therefore,  both  mental  processes  give  unlimited  range  to  the  imagination. 

But  both#have  an  immortal  object,  in  as  far  as  the  bliss  which  the 
sexual  sentiment  creates  in  fancy  seems  incomparable  and  infinite  in  con- 
trast with  all  other  pleasurable  feelings ;  and  the  same  is  true  of  the 
promised  blessings  of  faith,  which  are  conceived  to  be  eternal  and  supreme. 

From  the  correspondence  between  the  two  states  of  conscious- 
ness, with  reference  to  the  commanding  importance  of  their  objects,  it 
follows  that  they  both  often  attain  an  intensity  that  is  irresistible,  and 
which  overcomes  all  opposing  motives.  Owing  to  their  similarity  in  that 
their  objects  cannot  be  attained,  it  follows  that  both  easily  degenerate 
into  silly  enthusiasm,  in  which  the  intensity  of  feeling  far  surpasses  the 
clearness  and  constancy  of  the  ideas.  In  both  cases,  in  this  enthusiasm, 
with  the  expectation  of  a  happiness  that  cannot  be  attained,  the  necessity 
of  unconditional  submission  plays  a  part. 

Owing  to  the  correspondence  in  many  points  between  these  two 
emotional  states,  it  is  clear  that  when  they  are  very  intense  the  one  may 
take  the  place  of  the  other ;  or  one  may  appear  by  the  side  of  the  other, 
since  every  intensification  of  one  element  of  mental  life  also  intensifies  its 
associations.  The  constant  emotion  thus  calls  into  consciousness  now 
one  and  now  the  other  of  the  two  series  of  ideas  with  which  it  is  con- 
nected. Either  of  these  mental  states  may  become  transformed  into  the 
impulse  to  cruelty  (actively  exercised  or  passively  suffered). 

In  the  religious  life  this  is  expressed  by  sacrifice.  Primarily  this  is 
done  with  the  idea  that  the  victim  is  materially  enjoyed  by  the  deity; 
then,  in  reverence,  as  a  sign  of  submission,  as  a  tribute  ;  and,  finally,  with 
the  belief  that  sins  and  transgressions  against  the  deity  are  thus  atoned 


10  PSYCHOPATHIA    SEXUALIS. 

for  and  blessing  obtained.  If,  however,  the  offering  consist  of  self-punish- 
ment, which  occurs  in  all  religions,  in  individuals  of  very  excitable  re- 
ligious nature,  it  serves  not  only  as  a  symbol  of  submission  and  as  an 
equivalent  in  the  exchange  of  present  pain  for  future  bliss,  but  everything 
that  is  thought  to  come  from  the  deity,  all  that  happens  in  obedience  to 
divine  mandate  or  to  the  honor  of  the  godhead,  is  felt  directly  as  pleasure. 
Thus  religious  enthusiasm  leads  to  ecstasy,  to  a  condition  in  which  con- 
sciousness is  so  preoccupied  with  feelings  of  mental  pleasure  that  the 
concept  of  suffering  endured  can  only  be  apperceived  without  its  painful 
quality. 

The  exaltation  of  religious  enthusiasm  may  lead  actively  to  pleasure 
in  the  sacrifice  of  another,  if  pity  be  overcompensated  by  feelings  of 
religious  pleasure. 

Sadism,  and  particularly  masochism  (v.  infra),  show  that  in  the 
sphere  of  the  sexual  life  there  may  be  similar  phenomena.  Thus  the 
well-established  relations  between  religion,  lust,  and  cruelty1  may  be 
comprehended  in  the  following  formula :  States  of  religious  and  sexual 
excitement,  at  the  acme  of  their  development,  may  correspond  in  the 
amount  and  quality  of  excitement,  and,  therefore,  under  favoring  cir- 
cumstances, one  may  take  the  place  of  the  other.  Both,  in  pathological 
conditions,  may  become  transformed  into  cruelty.  • 

The  sexual  factor  proves  to  be  no  less  influential  in  awaken- 
ing aesthetic  feelings.  What  would  poetry  and  art  be  without  a 
sexual  foundation  1  In  (sensual)  love  is  gained  that  warmth  of 
fancy  without  which  a  true  creation  of  art  is  impossible ;  and  in 
the  fire  of  sensual  feelings  its  glow  and  warmth  are  preserved. 
It  may  thus  be  understood  why  great  poets  and  artists  have 
sensual  natures. 

This  world  of  ideals  reveals  itself  with  the  inception  of  the 
processes  of  sexual  development.  He  who,  at  this  period  of  life, 
cannot  become  enthusiastic  for  all  that  is  great,  noble,  and 
beautiful,  remains  a  Philistine  all  his  life.  At  this  epoch  does 
not  the  least  of  natural  poets  forge  verses  1 

At  the  limits  of  physiological  reaction  there  are  events 
which  take  place  at  the  time  of  puberty  in  which  these  obscure 
feelings  of  longing  express  themselves  in  paroxysms  of  despair 


1  The  relation  of  this  trio  finds  its  expression  not  only  in  the  events  of  real  life,  as 
above  indicated,  but  also  in  romance,  and  even  in  the  sculpture  of  degenerate  eras.  As  an 
example  we  may  point  to  the  group  of  St.  Theresa,  by  Bernini,  who  "  sinks  in  an  hysterical 
faint  on  a  marble  cloud,  with  an  amorous  angel  plunging  the  arrow  (of  divine  love)  into 
her  heart "  (Lfibke). 


PSYCHOLOGY   OF   THE   SEXUAL   LIFE.  11 

of  self  and  the  world,  which  may  go  on  to  tcedium  vitce,  and  are 
often  accompanied  by  a  desire  to  do  harm  to  others  (weak 
analogies  of  a  psychological  connection  between  lust  and 
cruelty). 

Youthful  love  has  a  romantic,  idealistic  character.  It 
elevates  the  beloved  object  to  apotheosis.  In  its  inception  it  is 
platonic,  and  turns  to  forms  of  poetry  and  romance.  With  the 
awakening  of  sensuality  there  is  danger  that  this  idealizing 
power  may  be  brought  to  bear  upon  persons  of  the  opposite  sex 
who  are  mentally,  physically,  and  socially  of  inferior  station. 
Thus  there  may  occur  rnessalUances,  seductions,  and  errors,  with 
the  whole  tragedy  of  a  passionate  love  that  comes  in  conflict  with 
the  dictates  of  social  position  and  prospects,  and  sometimes 
terminates  in  suicide  or  double  suicide. 

Over-sensual  love  can  never  be  lasting  and  true.  For  this 
reason  the  first  love  is,  as  a  rule,  very  fleeting ;  because  it  is  nothing 
else  than  the  flare  of  a  passion,  the  flame  of  a  fire  of  straw. 

Only  the  love  that  rests  upon  a  recognition  of  the  social 
qualities  of  the  beloved  person,  only  a  love  which  is  willing  not 
only  to  enjoy  present  pleasures,  but  to  bear  suffering  for  the 
beloved  object  and  sacrifice  all,  is  true  love.  The  love  of  a 
strongly  constituted  man  shrinks  before  no  difficulties  or  dangers 
in  order  to  gain  and  keep  possession  of  its  object. 

Love  expresses  itself  in  acts  of  heroism  and  daring.  Such 
love  is  in  danger,  under  certain  circumstances,  of  becoming 
criminal,  if  moral  principles  be  weak.  Jealousy  is  an  ugly  spot 
in  this  love.  The  love  of  a  weekly  constituted  man  is  senti- 
mental. It  sometimes  leads  to  suicide  when  it  is  not  returned 
or  meets  with  obstacles,  while,  under  like  conditions,  the  strongly 
constituted  man  may  become  a  criminal. 

Sentimental  love  is  in  danger  of  becoming  a  caricature,  i.e., 
when  the  sensual  element  is  weak  (the  Knight  of  Toggenburg, 
Don  Quixote,  many  minnesingers  and  troubadours  of  the  Middle 
Ages). 

Such  love  is  flat  and  soft,  and  may  be  even  silly ;  but  the 
true  expression  of  this  powerful  feeling  awakens  appropriate 
pity,  respect,  or  sorrow  in  the  hearts  of  others. 


12  PSYCOPATHIA   SEXUALIS. 

Frequently  this  weak  love  expresses  itself  in  equivalents — 
in  poetry,  which,  however,  under  such  circumstances,  is  effemi- 
nate ;  in  aesthetics  which  are  overdrawn ;  in  religion,  in  which 
it  gives  itself  up  to  mysteries  and  religious  enthusiasm ;  or, 
where  there  is  a  more  powerful  sensual  foundation,  founds  sects 
or  expresses  itself  in  religious  insanity.  The  immature  love 
of  the  age  of  puberty  has  something  of  all  this  in  it.  Of  all  the 
poems  and  rhymes  written  at  this  time  of  life,  they  only  are 
readable  that  are  the  product  of  poets  divinely  endowed. 

Notwithstanding  all  the  ethics  which  love  requires  in  order 
to  develop  into  its  true  and  pure  form,  its  strongest  root  is  still 
sensuality.  Platonic  love  is  an  impossibility,  a  self-deception,  a 
false  designation  for  related  feelings. 

In  as  far  as  love  rests  upon  sensual  desire,  it  is  only  con- 
ceivable in  a  normal  way  as  existing  between  individuals  of 
opposite  sex  and  capable  of  sexual  intercourse.  If  these  con- 
ditions are  wanting  or  destroyed,  then,  in  the  place  of  love, 
comes  friendship. 

The  role  which  the  retention  of  sexual  functions  plays  in 
the  case  of  a  man,  both  in  originating  and  retaining  the  feeling 
of  self-respect,  is  remarkable.  In  the  deterioration  of  manliness 
and  self-confidence  which  the  onanist,  in  his  weakened  nervous 
state,  and  the  man  that  has  become  impotent,  present,  may  be 
estimated  the  significance  of  this  factor. 

Gyurkovechky  (mannl.  Impotenz.  Yienna,  1889)  says,  very  justly, 
that  old  and  young  men  essentially  differ  mentally,  on  account  of  the  con- 
dition of  their  virility,  and  that  impotence  has  a  detrimental  effect  upon 
the  feeling  of  well-being,  mental  freshness,  activity,  self-confidence,  and  the 
play  of  fancy.  This  loss  becomes  the  more  important  the  younger  a  man 
is  when  he  loses  his  virility  and  the  more  sensually  he  was  constituted. 

Under  such  circumstances  a  sudden  loss  of  virility  may  induce  severe 
melancholia,  and  even  lead  to  suicide.  For  such  natures  life  without  love 
is  unbearable. 

But,  also,  in  cases  where  the  reaction  is  not  so  deep,  the  man  bereft 
of  his  virility  is  morose  and  spiteful,  egotistic,  jealous,  contrary,  listless, 
has  but  little  self-respect  or  sense  of  honor,  and  is  cowardly.  Analogies 
are  seen  in  the  Skopzens,1  who,  after  their  castration,  change  for  the 
worse. 

1  A  Russian  religious  sect. 


PSYCHOLOGY  OF   THE   SEXUAL   LIFE.  13 

The  loss  of  virility  is  still  more  noticeable  in  certain  weekly  con- 
stituted individuals,  where  it  expresses  itself  in  formal  effemination  (v. 
infra). 

In  a  woman  who  has  become  a  matron  the  condition  is  of 
much  less  importance  psychologically,  though  it  is  noticeable. 
If  the  past  period  of  sexual  life  has  been  satisfactory,  if  chil- 
dren delight  the  heart  of  the  aging  mother,  then  she  is  scarcely 
conscious  of  the  change  of  her  personality. 

The  situation  is  different,  however,  where  sterility  or  circum- 
stances have  kept  a  woman  from  the  performance  of  her  natural 
functions  and  denied  her  that  happiness. 

These  facts  place  in  a  clear  light  the  differences  which  exist 
between  man  and  woman  in  the  psychology  of  the  sexual  life, 
and  in  all  the  sexual  functions  and  desires. 

Undoubtedly  man  has  a  much  more  intense  sexual  appetite 
than  woman.  As  a  result  of  a  powerful  natural  instinct,  at  a 
certain  age,  a  man  is  drawn  toward  a  woman.  He  loves  sen- 
sually, and  is  influenced  in  his  choice  by  physical  beauty.  In 
accordance  with  the  nature  of  this  powerful  impulse,  he  is 
aggressive  and  violent  in  his  wooing.  At  the  same  time,  this 
demand  of  nature  does  not  constitute  all  of  his  mental  existence. 
When  his  longing  is  satisfied,  love  temporarily  retreats  behind 
other  vital  and  social  interests. 

With  a  woman  it  is  quite  otherwise.  If  she  is  normally 
developed  mentally,  and  well  bred,  her  sexual  desire  is  small. 
If  this  were  not  so  the  whole  world  would  become  a  brothel 
and  marriage  and  a  family  impossible.  It  is  certain  that  the 
man  that  avoids  women  and  the  woman  that  seeks  men  are 
abnormal. 

Woman  is  wooed  for  her  favor.  She  remains  passive. 
This  lies  in  her  sexual  organization,  and  is  not  founded  merely 
on  the  dictates  of  good  breeding. 

Nevertheless,  the  sexual  sphere  occupies  a  much  larger  place 
in  the  consciousness  of  woman  than  in  that  of  man.  The  need 
of  love  in  her  is  greater  than  in  man,  and  is  continual,  not  inter- 
mittent; but  this  love  is  rather  more  spiritual  than  sensual. 
While  a  man  loves  a  woman  first  as  wife  and  then  as  mother  of 


1"4  PSYCHOPATHIA   SEXUALIS. 

• 

his  children,  a  woman  is  primarily  conscious  of  a  man  as  the 
father  of  her  children  and  then  as  husband.  In  the  choice  of  a 
life-companion  a  woman  is  influenced  much  more  by  the  mental 
than  the  physical  qualities  of  a  man.  When  she  has  become 
a  mother  she  divides  her  love  between  child  and  husband. 
Sensuality  disappears  in  the  mother's  love.  Thereafter,  in 
marital  intercourse,  the  wife  finds  less  sensual  satisfaction  than 
proof  of  the  love  of  her  husband. 

A  woman  loves  with  her  whole  soul.  To  her  love  is  life ; 
to  a  man  it  is  the  joy  of  life.  To  him  misfortune  in  love  is  a 
wound ;  but  it  costs  a  woman  her  life,  or  at  least  her  happiness. 
A  psychological  question  worthy  of  consideration  is  whether  a 
woman  can  truly  love  twice  in  her  life.  Certainly  the  mental 
inclination  of  woman  is  monogamous,  while  in  man  it  is 
polygamous. 

The  weakness  of  men  in  comparison  with  women  lies  in  the 
great  intensity  of  their  sexual  desires.  Man  becomes  dependent 
upon  woman,  and  the  more,  the  weaker  and  more  sensual  he 
becomes ;  and  this  just  in  proportion  as  he  becomes  neuropathic. 
Thus  may  be  understood  the  fact  that,  in  times  of  effeminateness 
and  luxury,  sensuality  flourishes  luxuriantly.  Then  arises  the 
danger  to  society  that  mistresses  and  their  dependents  may  rule 
the  state  and  compass  its  ruin  (the  mistresses  of  the  courts  of 
Louis  XIV  and  XV ;  the  prostitutes  of  ancient  Greece). 

The  biographies  of  many  statesmen  of  ancient  and  modern 
times  show  that  they  were  the  instruments  of  women,  owing  to 
their  great  sensuality,  which  had  its  foundation  in  their  neuro- 
pathic constitutions.  The  fact  that  the  Catholic  Church  enjoins 
celibacy  upon  its  priests,  in  order  to  emancipate  them  from 
sensuality  and  preserve  them  entirely  for  the  purpose  of  their 
calling,  is  an  example  of  discerning  psychological  knowledge 
of  mankind;  but  it  is  unfortunate  that  the  priests,  living  in 
celibacy,  lose  the  elevating  effect  which  love  and  matrimony 
exert  upon  the  development  of  character. 

From  the  fact  that  man  by  nature  plays  the  aggressive 
role  in  sexual  life,  he  is  in  danger  of  overstepping  the  limits 
which"  morality  and  law  have  set.    The  unfaithfulness  of  a  wife, 


PSYCHOLOGY   OF   THE   SEXUAL   LIFE.  15 

in  comparison  with  that  of  a  husband,  is  morally  much  more 
weighty,  and  should  be  more  severely  punished  legally.  The 
unfaithful  wife  dishonors  not  only  herself,  but  also  her  husband 
and  her  family,  not  to  speak  of  the  possibility  of  pater  incertus. 
Natural  instinct  and  social  position  favor  unfaithfulness  on  the 
part  of  a  husband,  while  the  wife  is  afforded  much  protection. 
In  the  case  of  an  unmarried  woman,  sexual  intercourse  is  some- 
thing quite  different  from  what  it  is  in  an  unmarried  man.  Of 
a  single  man  society  demands  decency ;  of  a  woman,  also 
chastity.  In  the  cultivated  social  life  of  to-day,  woman,  occupy- 
ing a  sexual  position  and  concerning  herself  in  the  interests  of 
society,  can  only  be  thought  of  as  a  wife. 

The  aim  and  ideal  of  woman,  even  when  she  is  sunken  in 
the  mire  of  vice,  is,  and  remains,  marriage.  Woman,  as  Man- 
tegazza  justly  remarks,  desires  not  only  satisfaction  of  her  sexual 
feeling,  but  also  protection  and  support  for  herself  and  her  chil- 
dren. A  man  of  right  feeling,  no  matter  how  sensual  he  may 
be,  demands  a  wife  that  has  been,  and  is,  chaste.  The  emblem 
and  ornament  of  a  woman  seeking  this,  her  only  worthy  purpose 
in  life,  is  modesty.  Mantegazza  finely  characterizes  modesty 
as  "  one  of  the  forms  of  psychical  self-respect  "  in  woman.  This 
is  not  the  place  for  anthropological  and  historical  consideration 
of  this,  the  most  beautiful  attribute  of  woman.  Probably, 
feminine  modesty  is  an  hereditarily  evolved  product  of  the 
development  of  civilization.1 

In  remarkable  contrast  with  it,  there  is  occasional  exposi- 
tion of  physical  charms,  conventionally  sanctioned  by  the  law 
of  fashion,  in  which  even  the  most  discreet  maiden  allows  her- 
self to  indulge  in  the  ball-room.  The  reasons  which  lead  to 
this  display  are  evident.  Fortunately  the  modest  girl  is  as  little 
conscious  of  them  as  of  the  reason  for  the  occasionally  recur- 
ring mode  of  making  certain  portions  of  the  body  more  promi- 
nent (panniers)  ;  to  say  nothing  of  corsets,  etc. 

1  Westermarck  (op.  cit.,  p.  211),  after  a  careful  review  of  the  evidence,  says  :  "  These 
facts  appear  to  prove  that  the  feeling  of  shame,  far  from  being  the  original  cause  of  man's 
covering  his  body,  is,  on  the  contrary,  a  result  of  this  custom  ;  and  that  the  covering,  if  not 
used  as  a  protection  from  climate,  owes  its  origin,  at  least  in  a  great  many  cases,  to  the 
desire  of  meu  and  women  to  make  themselves  attractive." — Trans. 


16  PSYCHOPATHIA   SEXUALIS. 

In  all  times,  and  among  all  races,  women  show  a  desire  to 
adorn  themselves  and  be  charming.1  In  the  animal  kingdom 
nature  has  distinguished  the  male  with  the  greater  beauty.  Men 
designate  women  as  the  beautiful  sex.  This  gallantry  clearly 
arises  from  the  sensual  desire  of  men.  As  long  as  this  personal 
adornment  has  a  purpose  only  in  itself,  or  the  true  psychological 
reason  of  the  desire  to  please  remains  unknown  to  the  woman, 
nothing  can  be  said  against  it.  When  it  is  done  with  knowl- 
edge, the  effort  is  called  flirting. 

Under  all  circumstances  a  dandified  man  is  ridiculous.  We 
are  accustomed  to  this  slight  weakness  in  a  woman,  and  find  no 
fault  with  it,  so  long  as  it  is  but  a  subordinate  manifestation. 
When  it  has  become  the  all-absorbing  aim,  the  French  apply  to 
it  the  word  coquetry. 

Woman  far  surpasses  man  in  the  natural  psychology  of 
love,  partly  because,  through  heredity  and  education,  her  native 
element  is  love  ;  and  partly  because  she  has  finer  feelings  (Man- 
tegazza).  Even  in  a  man  of  the  very  highest  breeding,  it  cannot 
be  found  objectionable  that  he  recognizes  woman  as  a  means  of 
satisfying  his  natural  instinct.  But  it  becomes  his  duty  to  belong 
only  to  the  woman  of  his  choice.  In  a  civilized  state  this 
becomes  a  binding  social  obligation, — marriage ;  and,  inasmuch 
as  the  wife  requires  for  herself  and  children  protection  and  sup- 
port, it  becomes  a  marriage  right. 

It  is  of  great  importance  psychologically,  and,  for  certain  pathologi- 
cal manifestations  to  be  later  described,  indispensable,  to  examine  the  psy- 
chological events  which  draw  a  man  and  a  woman  together  and  unite  them ; 
so  that,  of  all  other  persons  of  the  same  sex,  only  the  beloved  one  seems 
desirable. 

If  one  could  demonstrate  design  in  the  processes  of  nature, — adapta- 
tion cannot  be  denied  them,— the  fact  of  fascination  by  a  single  person  of 
the  opposite  sex,  with  indifference  toward  all  others,  as  it  occurs  between 
true  and  happy  lovers,  would  appear  as  a  wonderful  creative  provision  to 
insure  monogamous  unions  for  the  promotion  of  their  object. 

1  This  is  not  literally  the  case.  "It  is  expressly  stated,  of  the  women  of  several 
savage  peoples,  that  they  are  less  desirous  of  self-decora tiou  than  the  men." — Westermarck, 
op.  cit.,  p.  184.  And  the  same  writer  (p.  182)  says  that  "  it  is  a  common  notion  that  women 
are  hy  nature  vainer  and  more  addicted  to  dressing  and  decorating  themselves  than  men. 
This  certainly  does  not  hold  good  for  savage  and  barbarous  peoples  in  general." — Tbanb. 


PSYCHOLOGY   OF   THE   SEXUAL   LIFE.  17 

To  the  scientific  observer,  however,  this  love,  or  "  harmony  of  souls," 
this  "  heart-bond,"  does  not,  by  any  means,  appear  as  a  "  soul-mystery ;" 
but,  in  the  majority  of  cases,  it  may  be  referred  to  certain  physical  or 
mental  peculiarities,  as  the  case  may  be,  by  which  the  attractiveness  of 
the  beloved  person  is  exerted. 

Thus  we  speak  of  what  is  called  fetich  and  fetichism.  In  the 
term  fetich  we  are  wont  to  comprehend  objects,  or  parts,  or  simply  pecu- 
liarities of  objects,  which,  by  virtue  of  associative  relations  to  an  intense 
feeling,  or  to  a  personality  or  idea  that  awakens  deep  interest,  exert  a 
kind  of  charm  {"  fetisso"  Portuguese),  or,  at  least,  owing  to  peculiar 
individual  coloring,  produce  a  very  deep  impression  which  does  not  belong 
to  the  external  sign  (symbol,  fetich)  in  itself.1 

The  individual  valuation  of  the  fetich,  which  may  go  to  the  extent 
of  an  unreasoning  enthusiasm  in  the  individual  affected,  is  called  fetichism. 
This  interesting  psychological  phenomenon  is  explicable  by  an  empirical 
law  of  association, — the  relation  of  a  particular  to  a  general  concept, — in 
which,  however,  the  essential  thing  is  the  pleasurable  emotional  coloring 
of  the  particular  concept  peculiar  to  the  individual!  It  is  most  common 
in  two  related  mental  spheres, — those  of  religious  and  erotic  feelings  and 
ideas.  Religious  fetichism  differs  in  relation  and  significance  from  sexual 
fetichism,  for  it  found,  and  still  finds,  its  original  motive  in  the  delusion 
that  the  object  of  the  fetichism,  or  the  idol,  possesses  divine  attributes, 
and  that  it  is  not  simply  a  symbol ;  or  peculiar  wonder-working  (relics) 
or  protective  (amulet)  virtues  are  superstitiously  ascribed  to  the  fetich. 

It  is  otherwise  with  erotic  fetichism,  which  finds  its  psychological 
motive  in  fetiches  which  consist  of  physical  or  mental  qualities  of  a 
person,  or  even  merely  of  objects  which  a  person  has  used.  These 
always  awaken  intense  associative  ideas  of  the  personality  as  a  whole, 
and,  moreover,  are  always  colored  with  a  lively  feeling  of  sexual  pleasure. 
Analogies  with  religious  fetichism  are  always  discernible;  for,  under 
certain  circumstances,  in  the  latter,  the  most  insignificant  objects  (bones, 
nails,  hair,  etc.)  become  fetiches,  and  are  associated  with  pleasurable 
feelings  which  may  reach  the  intensity  of  ecstasy. 

With  respect  of  the  development  of  physiological  love,  it  is 
probable  that  its  nucleus  is  always  to  be  found  in  an  individual 
fetich  (charm)  which  a  person  of  one  sex  exercises  over  a  person 
of  the  opposite  sex. 

The  case  is  the  simplest  where  the  sight  of  a  person  of  the 
opposite  sex  occurs  simultaneously  with  sensual  excitement,  and 
the  latter  is  thus  increased. 

1  Comp.  Max  Mtiller,  who  derives  the  word  fetich  etymologically  from  factitious  (arti- 
ficial, an  insignificant  thing). 

2 


18  PSYCOPATHIA    SEXUALIS. 

Emotional  and  visual  impressions  are  brought  into  associa- 
tive connection,  and  this  association  is  strengthened  in  propor- 
tion as  the  recurring  emotion  awakens  the  visual  memory-picture, 
or  the  latter  (another  meeting)  renews  sexual  excitement,  which 
may  possibly  reach  the  intensity  of  orgasm  and  pollution  (dream- 
picture).  In  this  case  the  whole  physical  personality  has  the 
effect  of  a  fetich. 

As  Binet  and  others  show,  merely  parts  of  the  whole, 
simply  peculiarities,  either  physical  or  mental,  may  affect  the 
person  of  the  opposite  sex  as  a  fetich,  when  the  perception 
of  them  is  associated  with  (accidental)  sexual  excitement  (or 
induces  it). 

It  is  well  known  from'  experience  that  accident  determines 
this  mental  association,  that  the  objects  of  the  fetich  may  be 
individually  very  diverse,  and  that  thus  the  most  peculiar  sym- 
pathies (and  antipathies)  arise. 

These  physiological  facts  of  fetichism  explain  the  individual 
sympathies  between  husband  and  wife;  the  preference  of  a 
certain  person  to  all  others  of  the  same  sex.  Since  the  fetich 
represents  a  symbol  that  is  purely  individual,  it  is  clear  that  its 
effect  must  be  individual.  Since  it  is  colored  by  the  most  intense 
pleasurable  feeling,  it  follows  that  possible  faults  in  the  beloved 
object  are  overlooked  ("Love  is  blind"),  and  an  exaltation  of  it 
is  induced  that  to  others  is  incomprehensible,  and  even  silly 
under  some  circumstances.  Thus  it  is  clear  why  lovers  are  not 
understood  by  their  unaffected  fellow-men  ;  and  why  they  deify 
their  idols,  develop  a  true  cult  of  devotion,  and  invests  them 
with  attributes  which  objectively  they  do  not  possess.  Thus  we 
may  understand  why  love  appears  sometimes  more  like  a  passion, 
sometimes  as  a  formal,  exceptional  mental  state,  in  which  the 
unattainable  seems  attainable,  the  ugly  beautiful,  the  profane 
sacred,  and  every  other  interest,  every  duty,  disappears. 

Tarde  (Archives  de  V antliropologie  criminelle,  v  year,  No. 
30)  rightfully  emphasizes  the  fact  that  the  fetich  may  vary  with 
nations  as  well  as  with  individuals,  but  that  the  general  ideal 
of  beauty  remains  the  same  among  civilized  people  of  the  same 
era. 


PSYCHOLOGY   OF  THE   SEXUAL   LIFE.  19 

Biiiet  deserves  great  credit  for  having  studied  and  analyzed 
in  detail  the  fetichism  of  love.  The  particular  sympathies  all 
spring  from  it.  Thus  one  is  attracted  to  slender,  another  to 
plump  beauties,  to  blondes  or  brunettes.  For  one  a  peculiar 
expression  of  the  eyes ;  for  another  a  peculiar  tone  of  the  voice, 
or  a  particular  (even  an  artificial)  odor  (perfume) ;  or  the  hand, 
the  loot,  the  ear,  etc.,  may  be  the  individual  fetich  (charm), — 
the  beginning  of  a  complicated  chain  of  mental  processes  which, 
as  a  whole,  represent  love,  i.e.,  the  longing  to  possess,  physically 
and  mentally,  the  beloved  object. 

This  fact  is  important,  as  showing  a  condition  for  the  origin 
of  a  fetichism  that  falls  within  physiological  limits.  The  fetich 
may  constantly  retain  its  significance  without  being  pathological; 
but  this  is  possible  only  when  the  particular  concept  is  developed 
to  a  general  concept ;  when  the  resulting  love  comes  to  take  as 
its  object  the  whole  mental  and  physical  personality. 

Normal  love  can  be  nothing  but  a  synthesis,  a  generaliza- 
tion. Ludwig  Brunn,1  under  the  heading,  "  The  Fetichism  of 
Love,"  cleverly  says : — 

"Thus  normal  love  appears  to  us  as  a  symphony  of  tones 
of  all  kinds.  It  results  from  the  most  various  stimuli.  It  is 
likewise  polytheistic.  Fetichism  recognizes  only  the  tone  of 
a  single  instrument;  it  results  from  a  certain  stimulus;  it  is 
monotheistic." 

On  slight  reflection  any  one  will  see  that  real  love  (this 
word  is  only  too  often  abused)  can  be  spoken  of  only  when  the 
whole  person  is  both  physically  and  mentally  the  object  of 
adoration.  Love  must  always  have  a  sensual  element,  i.e.,  the 
desire  to  possess  the  beloved  object,  to  be  united  with  it  and 
fulfill  the  laws  of  nature.  But  when  merely  the  body  of  the 
person  of  the  opposite  sex  is  the  object  of  love,  when  satisfaction 
of  sensual  pleasure  is  the  sole  object,  without  desire  to  possess 
the  soul  and  enjoy  mutual  communion,  love  is  not  genuine,  no 
more  than  that  of  platonic  lovers,  who  love  only  the  soul  and 
avoid  sensual  pleasure  (many  cases  of  contrary  sexuality).  For 
the  former  merely  the  body,  for  the  latter  simply  the  soul,  is  a 

1  Deuteches  Moutagsblatt,  Berlin,  August  20,  1888. 


20  PSYCHOPATHIA    SEXUALIS. 

fetich,  and  the  love  fetichism.  Such  cases  certainly  represent 
transitions  to  pathological  fetichism.  This  assumption  is  even 
more  justified  when,  as  a  further  criterion  of  real  love,  mental1 
satisfaction  must  be  given  by  the  sexual  act. 

There  remains  to  be  mentioned,  within  the  physiological 
phenomena  of  fetichism,  the  fact  that  among  the  many  things 
that  may  become  fetiches  there  are  certain  ones  that  gain  such 
significance  for  a  majority  of  persons. 

As  such  for  a  man  may  be  mentioned  the  hair,  the  hand, 
the  foot  of  a  woman,  the  expression  of  her  eyes.  Certain  ones 
of  these  gain  a  remarkable  significance  in  the  pathology  of 
fetichism.  These  facts  clearly  play  a  role  in  the  feminine  mind, 
either  consciously  or  unconsciously. 

One  of  the  greatest  cares  of  women  is  the  cultivation  of  the 
hair,  to  which  often  an  unreasonable  amount  of  time  and  money 
is  devoted.  How  a  mother  cares  for  her  little  daughter's  hair ! 
What  a  part  the  hair-dresser  plays!  Falling  of  the  hair  would 
cause  despair  in  a  young  lady.  I  recall  a  proud  lady  who 
became  insane  over  it,  and  died  by  suicide.  Young  ladies  like 
to  talk  of  coiffures,  and  are  envious  of  beautiful  hair.2 

1  Magnan's  "  spinal  cerebral  posterieur,"  who  finds  pleasure  in  every  woman,  and  on 
whom  every  woman  looks  with  favor,  has  only  desire  to  satisfy  his  lust.  Purchased  or 
forced  love  is  not  real  love  (Mantegazza).  The  one  who  originated  the  saying,  "  Sublata 
lucerna  nullum  discrimen  inter  femiuas,"  must  have  been  a  cynic  indeed.  Power  in  a  man 
to  perform  love's  act  is  no  proof  that  this  makes  possible  the  greatest  pleasure  of  love. 
There  are,  indeed,  urnings  who  are  potent  for  women, — men  who  do  not  love  their  wives, 
but  who  are  still  able  to  perform  the  marital  "  duty."  In  most  cases  of  this  kind,  indeed, 
there  is  no  lustful  pleasure ;  it  is  essentially  a  kind  of  onanistic  act,  for  the  most  part  made 
possible  by  means  of  help  of  imagination  that  calls  up  another  beloved  person.  By  this 
deception  sensual  pleasure  can  be  induced,  but  this  rudimentary  psychical  satisfaction  is 
the  result  of  a  mental  trick,  just  as  in  solitary  onanism,  where  fancy  has  to  assist  in  order 
to  induce  sensual  pleasure.  As  a  rule,  the  degree  of  orgasm  necessary  as  a  means  to  the 
attainment  of  lustful  pleasure  seems  attainable  only  when  the  imagination  intervenes. 
Where  mental  impediments  exist  (indifference,  repugnance,  disgust,  fear  of  infection  or 
pregnancy,  etc.),  sensual  pleasure  seems  usually  wanting. 

2  "The  important  part  played  by  the  hair  of  the  head  as  a  stimulant  of  sexual 
passion  appears  in  a  curious  way  from  Mr.  Sibree's  account  of  King  Radama's  attempt  to 
introduce  European  customs  among  the  Hovas  of  Madagascar.  As  soon  as  he  had  adopted 
the  military  tactics  of  the  English,  he  ordered  that  all  his  officers  and  soldiers  should  have 
their  hair  cut,  but  this  command  produced  so  great  a  disturbance  among  the  women  of 
the  capital  that  they  assembled  in  great  numbers  to  protest  against  the  king's  order,  and 
could  not  be  quieted  until  they  were  surrounded  by  troops,  and  their  leaders  cruelly 
speared." — Westermarck,  op.  cit. 

Here  male  hair  was  a  physiological  fetich  of  females.  It  represents  a  relation  of 
the  sexes  that  civilization  has  gradually  reversed.    While  in  civilized  society  woman  exer- 


PSYCHOLOGY   OF  THE   SEXUAL   LIFE.  21 

Beautiful  hair  is  a  powerful  fetich  with  many  men.  In 
the  legend  of  the  Loreley,  who  lured  men  to  destruction,  the 
golden  hair,  which  she  combs  with  a  golden  comb,  appears  as  a 
fetich.  Frequently  the  hand  and  foot  possess  an  attractiveness 
no  less  powerful,  when,  indeed,  often  (though  by  no  means  in- 
variably) masochistic  and  sadistic  feelings  aid  in  determining 
the  peculiar  kind  of  fetich. 

By  a  transference  through  association  of  ideas,  the  gloves 
or  shoes  may  obtain  the  significance  of  a  fetich. 

Brunn  (pp.  cit.)  justly  points  out  that  among  the  customs 
of  the  Middle  Ages  drinking  from  the  shoe  of  a  beautiful  woman 
(still  to  be  found  in  Poland)  played  a  remarkable  part  in  gal- 
lantry and  homage.  The  shoe  also  plays  an  important  role  in 
the  legend  of  Aschenbrodel. 

The  expression  of  the  eyes  is  particularly  important  as  a 
means  of  kindling  the  sparks  of  love.  A  neuropathic  eye  fre- 
quently affects  persons  of  both  sexes  as  a  fetich.  "  Madame,  vos 
beaux  yeux  me  font  mourir  d'amour  "  (Moliere). 

There  is  superfluity  of  examples  showing  that  odors  of  the 
body  may  become  fetiches. 

This  fact  is  also  taken  advantage  of  in  the  ars  amandi  of 
woman,  either  consciously  or  unconsciously.  Ruth  sought  to 
attract  Boaz  by  perfuming  herself.  The  demi-monde  of  ancient 
and  modem  times  is  noted  for  its  use  of  perfume.  Jager,  in 
his  "  Discovery  of  the  Soul,"  calls  attention  to  many  olfactory 
sympathies. 

Cases  are  known  where  men  have  married  ugly  women 
simply  because  their  personal  odors  were  exceedingly  pleasing. 

Binet  makes  it  probable  that  the  voice  may  also  become  a 
fetich.     He  relates  a  case  in  point  of  Dumas,  who  used  it  in  his 

ciscs  her  ingenuity  to  increase  her  attractiveness,  among  savages  it  is  the  men  who  are 
anxious  to  increase  their  physical  charms.  This  reversal  of  the  primitive  relation  is  a  very 
interesting  fact,  and  is  probably  to  be  explained  by  the  transference  of  the  "  liberty  of 
choice  "  from  woman  to  man  which  civilization  has  gradually  induced.  Westermarck  {op. 
cit.,  p.  185)  says:  "  It  should  be  noted  that  it  is,  as  a  rule,  the  man  only  that  runs  the  risk 
of  being  obliged  to  lead  a  single  life.  Hence  it  is  obvious  that,  to  the  best  of  his  ability, 
he  must  endeavor  to  be  taken  into  favor  by  making  himself  as  attractive  as  possible.  Iu 
civilized  Europe,  on  the  other  hand,  the  opposite  occurs.  Here  it  is  the  woman  that  has 
the  greatest  difficulty  in  getting  married,  and  she  is  also  the  vainer  of  the  two." — Tbans. 


22  PSYCHOPATHIA   SEXtJALlS. 

novel,  "  La  Maison  du  Vent."  It  was  the  case  of  a  wife  who 
fell  in  love  with  a  tenor's  voice,  and  thus  became  untrue  to  her 
husband.  Belot's  romance,  "  Les  Baigneuses  de  Trouville," 
speaks  in  favor  of  this  assumption.  Binet  thinks  that  many 
marriages  with  singers  are  due  to  the  fetich  of  their  voices.  He 
also  calls  attention  to  the  interesting  fact  that  among  singing- 
birds  the  voice  has  the  same  sexual  significance  as  odors  among 
quadrupeds.  The  birds  allure  by  their  song,  and  the  male  that 
sings  most  beautifully  flies  at  night  to  his  charmed  mate. 

The  pathological  facts  of  masochism  and  sadism  show  that 
mental  peculiarities  may  also  act  as  fetiches  in  a  wider  sense. 

Thus  the  fact  of  idiosyncrasies  is  explained,  and  the  old 
saying,  "  De  gustibus  non  est  disputandum"  retains  its  force. 


II.    PHYSIOLOGY. 


During  the  time  of  the  physiological  processes  in  the  reproductive 
glands,  desires  arise  in  the  consciousness  of  the  individual  which  have  for 
their  purpose  the  perpetuation  of  the  species  (sexual  instinct). 

Sexual  desire  during  the  years  of  sexual  maturity  is  a  physiological 
law.  The  duration  of  the  physiological  processes  in  the  sexual  organs, 
as  well  as  the  strength  of  the  sexual  desire  manifested,  vary,  both  in  indi- 
viduals and  in  races.  Race,  climate,  heredity,  and  social  circumstances 
have  a  very  decided  influence  upon  it.  The  greater  sensuality  of  southern 
races  as  compared  with  the  sexual  needs  of  those  of  the  North  is  well 
known.  Sexual  development  in  the  inhabitants  of  tropical  climes  takes 
place  much  earlier  than  in  those  of  more  northern  regions.  In  women 
of  northern  countries  ovulation,  recognizable  in  the  development  of  the 
body  and  the  occurrence  of  a  periodical  flow  of  blood  from  the  genitals 
(menstruation),  usually  begins  about  the  thirteenth  or  fifteenth  year;  in 
men  puberty,  recognizable  in  the  deepening  of  the  voice,  the  appearance 
of  hair  on  the  face  and  the  mons  veneris,  and  the  occasional  occurrence 
of  pollutions,  etc.,  takes  place  about  the  fifteenth  year.  In  the  inhabit- 
ants of  tropical  countries,  however,  sexual  development  takes  place 
several  years  earlier  in  women, — sometimes  as  early  as  the  eighth  year. 

It  is  worthy  of  remark  that  girls  who  live  in  cities  develop  about 
a  year  earlier  than  girls  living  in  the  country,  and  that  the  larger  the 
town  the  earlier,  ceteris  paribus,  the  development  takes  place. 

Heredity,  however,  has  no  small  influence  on  libido  and  sexual 
power.  Thus  there  are  families  in  which,  with  great  physical  strength 
and  longevity,  great  libido  and  virility  are  preserved  until  a  great  age, 
while  in  other  families  the  vita  sexualis  develops  late  and  is  early 
extinguished. 

In  women  the  time  of  the  activity  of  the  reproductive  glands  is 
shorter  than  in  men,  in  whom  the  sexual  function  may  last  until  a  great 
age.  Ovulation  ceases  about  thirty  years  after  puberty.  This  period  of 
cessation  of  activity  of  the  ovaries  is  called  the  change  of  life  (climac- 
terium). This  biological  phase  does  not  represent  merely  a  cessation  of 
function  and  final  atrophy  of  the  reproductive  organs,  but  also  a  trans- 
formation of  the  whole  organism.  In  Middle  Europe  the  sexual  maturity 
of  men  begins  about  the  eighteenth  year,  and  their  virility  reaches  its 
acme  at  forty.     After  that  age  it  slowly  declines. 

The  potentia  generandi  ceases  usually  at  the  age  of  sixty-two,  but 
potentia  coeundi  may  be  present  even  in  old  age.    The  existence  of  the 

(23) 


24  PSYCHOPATHIA   SEXUALIS. 

sexual  instinct  is  continuous  during  the  time  of  sexual  life,  but  it  varies  in 
intensity.  Under  physiological  conditions  it  is  never  intermittent  (period- 
ical), as  in  animals.  In  men  it  manifests  an  organic  variation  of  intensity 
in  consonance  with  the  collection  and  expenditure  of  semen ;  in  women 
the  increase  of  sexual  desire  coincides  with  the  process  of  ovulation,  and 
in  such  a  way  that  libido  sexualis  is  greater  after  the  menstrual  period. 

Sexual  instinct — as  emotion,  idea,  and  impulse — is  a  function  of  the 
cerebral  cortex.  Thus  far  no  definite  region  of  the  cortex  has  been 
proved  to  be  exclusively  the  seat  of  sexual  sensations  and  impulses.1 

Owing  to  the  close  relations  which  exist  between  the  sexual  instinct 
and  the  olfactory  sense,  it  is  to  be  presumed  that  the  sexual  and  olfactory 
centres  lie  close  together  in  the  cerebral  cortex.  The  development  of  the 
sexual  life  has  its  beginning  in  the  organic  sensations  which  arise  from 
the  "developing  reproductive  glands.  These  excite  the  attention  of  the 
individual.  Readings  and  the  experiences  of  every-day  life  (which,  un- 
fortunately, to-day  are  too  early  and  too  frequently  suggestive)  convert 
these  notions  into  clear  ideas.  These  become  accentuated  by  organic  sen- 
sations which  are  pleasurable.  With  this  accentuation  of  erotic  ideas  by 
lustful  feelings,  an  impulse  to  induce  these  (sexual  desire)  is  developed. 

Thus  there  is  established  a  mutual  dependence  between  the  cerebral 
cortex  (as  the  place  of  origin  of  sensations  and  ideas)  and  the  reproduc- 
tive organs.  The  latter,  by  reason  of  physiological  processes  (hyper- 
emia, secretion  of  semen,  ovulation),  give  rise  to  sexual  ideas,  images, 
and  impulses. 

The  cerebral  cortex,  by  means  of  apperceived  or  reproduced  sensual 
ideas,  reacts  on  the  reproductive  organs,  inducing  hyperemia,  secretion 
of  semen,  erection,  ejaculation.  This  results  by  means  of  centres  for 
vasomotor  innervation  and  ejaculation,  which  are  situated  in  the  lumbar 
portion  of  the  cord  and  lie  close  together.     Both  are  reflex  centres. 

The  erection-centre  (Goltz,  Eckhard)  is  an  intermediate  station 
placed  between  the  brain  and  the  genital  apparatus.  The  nervous  paths 
which  connect  it  with  the  brain  probably  run  through  the  pedunculi 
cerebri  and  the  pons.  This  centre  may  be  excited  by  central  (psychical 
and  organic)  stimuli,  by  direct  irritation  of  the  nerve-tract  in  the  pedun- 
culis  cerebri,  pons,  or  cervical  portion  of  the  cord,  as  well  as  bjr  periph- 
eral irritation  of  the  sensory  nerves  (penis,  clitoris,  and  annexa).  It  is 
not  directly  subordinated  to  the  will. 

The  excitation  of  this  centre  is  conveyed  to  the  corpora  cavernosa 
by  means  of  nerves  (nervi  erigentes — Eckhard)  running  in  the  first  three 
sacral  nerves. 

The  action  of  the  nervi  erigentes,  which  renders  erection  possible, 

i  The  olfactory  centre  is  presumed  by  Ferrier  ("  Functions  of  the  Brain  ")  to  be  in 
the  region  of  the  gyms  wicinatus.  Zuckerkandl  ("  Ueber  das  Riechcentrum,"  1887),  from 
researches  in  comparative  anatomy,  concludes  that  the  olfactory  centre  has  its  seat  in 
Amnion's  horn. 


PHYSIOLOGY.  25 

is  an  inhibitory  one.  They  inhibit  the  ganglionic  nervous  mechanism  in 
the  corpora  cavernosa  upon  the  action  of  which  the  smooth  muscle-fibres 
of  the  corpora  cavernosa  are  dependent  (Kolliker  and  Kohlrausch). 
Under  the  influence  of  the  action  of  the  nervi  erigentes  these  fibres  of  the 
corpora  cavernosa  become  relaxed  and  their  spaces  fill  with  blood.  Simul- 
taneously, as  a  result  of  the  dilatation  of  the  capillary  net-work  of  the 
corpora  cavernosa,  pressure  is  exerted  upon  the  veins  of  the  penis  and 
the  return  of  blood  is  impeded.  This  effect  is  aided  by  contraction  of 
the  bulbo  cavernosus  and  ischio  cavernosus  muscles,  which  are  inserted 
by  means  of  an  aponeurosis  on  the  dorsal  surface  of  the  penis. 

The  erection-centre  is  under  the  influence  of  both  exciting  and  in- 
hibitory innervation  arising  in  the  cerebrum.  Ideas  and  sense-percep- 
tions of  sexual  content  have  an  exciting  effect.  Also,  according  to 
observations  made  on  men  that  have  been  hung,  it  is  evident  that  the 
erection-centre  may  be  excited  by  excitation  of  the  tract  in  the  spinal 
cord.  Observations  on  the  insane  and  those  suffering  with  cerebral  dis- 
ease show  that  this  is  also  possible  as  a  result  of  organic  irritation  in  the 
cerebral  cortex  (psycho-sexual  centre  ?).  Spinal  diseases  (tabes,  especially 
myelitis)  affecting  the  lumbar  portion  of  the  cord,  in  their  earlier  stages, 
may  directly  excite  the  erection-centre. 

Reflex  excitation  of  the  centre  is  possible  and  frequent  in  the  fol- 
lowing ways  :  by  irritation  of  the  (peripheral)  sensory  nerves  of  the 
genitals  and  surrounding  parts  by  friction  ;  by  irritation  of  the  urethra 
(gonorrhoea),  of  the  rectum  (haemorrhoids,  oxyuris),  of  the  bladder 
(distension  with  urine,  especially  in  the  morning,  irritation  of  calculi)  ; 
by  distension  of  the  vesiculoe  seminales  with  semen ;  by  hyperemia  of 
the  genitals,  occasioned  by  lying  on  the  back,  and  thus  inducing  pressure 
of  the  intestines  upon  the  blood-vessels  of  the  pelvis. 

The  erection-centre  may  also  be  excited  by  irritation  of  the  nervous 
ganglia  which  are  so  abundant  in  the  prostatic  tissue  (prostatitis,  intro- 
duction of  catheter,  etc.). 

The  experiment  of  Goltz,  according  to  whom,  when  (in  dogs)  the 
lumbar  portion  of  the  cord  is  severed,  erection  is  more  easily  induced, 
shows  that  the  erection-centre  is  also  subject  to  inhibitory  influences  from 
the  brain. 

In  men  the  fact  that  the  will  and  emotions  (fear  of  unsuccessful 
coitus,  surprise  inter  actum  sexualem,  etc.)  may  inhibit  the  occurrence 
of  erection,  and  cause  it,  when  present,  to  disappear,  also  indicates  this. 

The  duration  of  erection  is  dependent  upon  the  duration  of  its  ex- 
citing causes  (sensory  stimuli),  the  absence  of  inhibitory  influences,  the 
nervous  energy  of  the  centre,  and  the  early  or  late  occurrence  of  ejacu- 
lation (v.  infra). 

The  central  and  highest  portion  of  the  sexual  mechanism  is  the 
cerebral  cortex.  It  is  justifiable  to  presume  that  there  is  a  definite  region 
of  the  cortex  (cerebral  centre)  which  gives  rise  to  sexual  feelings,  ideas, 


26  PSYCHOPATHIA   SEXUALIS. 

and  impulses,  and  is  the  place  of  origin  of  the  psycho-somatic  processes 
which  we  designate  as  sexual  life,  sexual  instinct,  and  sexual  desire.  This 
centre  is  excitable  to  both  central  and  peripheral  stimuli. 

Central  stimuli,  in  the  form  of  organic  excitation,  may  be  due  to 
diseases  of  the  cerebral  cortex.  Physiologically  they  consist  of  psy- 
chical stimuli  (memory  and  sensory  perceptions). 

Under  physiological  conditions  these  stimuli  are  essentially  visual 
perceptions  and  memory-pictures  (i.e.,  lascivious  stories)  and  also  tactile 
impressions  (touch,  pressure  of  the  hand,  kiss,  etc.). 

Within  physiological  limits  auditory  and  olfactory  perceptions  cer- 
tainly play  but  a  very  subordinate  role.  Under  pathological  conditions 
(v.  infra)  the  latter  have  a  very  decided  influence  in  inducing  sexual 
excitement. 

Among  animals  the  influence  of  olfactory  perceptions  on  the  sexual 
sense  is  unmistakable.  Althaus  ("  Beitrage  zur  Physiol,  und  Pathol,  des 
Olfactorius."  Archiv  fur  Psych.,  xii,  H  1)  declares  that  the  sense  of 
smell  is  important  with  reference  to  the  reproduction  of  the  species.  He 
shows  that  animals  of  opposite  sexes  are  drawn  to  each  other  by  means 
of  olfactory  perceptions,  and  that  almost  all  animals,  at  the  time  of  rut- 
ting, emit  a  very  strong  odor  from  their  genitals.  An  experiment  by 
Schiff  is  confirmatory  of  this.  He  extirpated  the  olfactory  nerves  in 
puppies,  and  found  that,  as  the  animals  grew,  the  male  was  unable  to 
distinguish  the  female.  On  the  other  hand,  an  experiment  by  Mante- 
gazza  ("  Hygiene  of  Love  ")r  who  removed  the  eyes  of  rabbits  and  found 
that  the  defect  constituted  no  obstacle  to  procreation,  shows  how  im- 
portant in  animals  the  olfactorj^  sense  is  for  the  vita  sexualis. 

It  is  also  remarkable  that  many  animals  (musk-ox,  civet-cat, 
beaver)  possess  glands  on  their  sexual  organs,  which  secrete  materials 
having  a  very  strong  odor. 

Althaus  also  shows  that  in  man  there  are  certain  relations  existing 
between  the  olfactory  and  sexual  senses.  He  mentions  Cloquet  ("  Osphre- 
siologie,"  Paris,  1826),  who  calls  attention  to  the  sensual  pleasure  excited 
by  the  odors  of  flowers,  and  tells  how  Richelieu  lived  in  an  atmosphere 
loaded  with  the  heaviest  perfumes,  in  order  to  excite  his  sexual  functions. 

Zippe  (  Wien.  Med.  Wochenschrift,  1879,  Nr.  24),  in  connection  with 
a  case  of  kleptomania  in  an  onanist,  likewise  establishes  such  relations, 
and  cites  Hildebrand  as  authority,  who  in  his  popular  physiology  says : 
"  It  cannot  be  doubted  that  the  olfactory  sense  stands  in  remote  connec- 
tion with  the  sexual  apparatus.  Odors  of  flowers  often  occasion  pleasur- 
able sensual  feelings,  and  when  one  remembers  the  passage  in  the  '  Song 
of  Solomon,' '  And  my  hands  dropped  with  myrrh  and  my  fingers  with 
sweet-smelling  myrrh  upon  the  handles  of  the  lock,'  one  finds  that  it  did 
not  escape  Solomon's  observation.  In  the  Orient  the  pleasant  perfumes 
are  esteemed  for  their  relation  to  the  sexual  organs,  and  the  women's 
apartments  of  the  Sultan  are  filled  with  the  perfumes  of  flowers," 


PHYSIOLOGY.  27 

Most,  professor  in  Rostock  (comp.  Zippe),  relates  :  "  I  learned  from 
a  sensual  young  peasant  that  he  had  excited  many  a  chaste  girl  sexually, 
and  easily  gained  his  end,  by  carrying  his  handkerchief  in  his  axilla  for  a 
time,  while  dancing,  and  then  wiping  his  partner's  perspiring  face  with  it." 

The  case  of  Henry  III  shows  that  contact  with  a  person's  perspira- 
tion may  be  the  exciting  cause  of  passionate  love.  At  the  betrothal 
feast  of  the  King  of  Navarre  and  Margaret  of  Valois,  he  accidentally 
dried  his  face  with  a  garment  of  Maria  of  Cleves,  which  was  moist  with 
her  perspiration.  Although  she  was  the  bride  of  the  Prince  of  Conde', 
Henry  conceived  immediately  such  a  passionate  love  for  her  that  he 
could  not  resist  it,  and  made  her,  as  history  shows,  very  unhappy.  An 
analogous  instance  is  related  of  Henry  IY,  whose  passion  for  the  beauti- 
ful Gabriel  is  said  to  have  originated  at  the  instant  when,  at  a  ball,  he 
wiped  his  brow  with  her  handkerchief. 

Professor  Jager,  the  "  discoverer  of  the  soul,"  refers  to  the  same 
thing  in  his  well-known  book  (2d  ed.,  1880,  chap,  xv,  p.  113);  for  he 
regards  the  sweat  as  important  in  the  production  of  sexual  effects  and 
as  being  especially  seductive. 

One  learns  from  reading  the  work  of  Ploss  ("  Das  Weib ")  that 
attempts  to  attract  a  person  of  the  opposite  sex  by  means  of  the  perspi- 
ration may  be  discerned  in  many  forms  in  popular  psychology. 

In  reference  to  this,  a  custom  which  holds  among  the  natives  of  the 
Philippine  Islands  when  they  become  engaged,  as  reported  by  Jager,  is 
remarkable.  "When  it  becomes  necessary  for  the  engaged  pair  to  separate, 
they  exchange  articles  of  wearing-apparel,  by  means  of  which  each  be- 
comes assured  of  faithfulness.  These  objects  are  carefully  preserved, 
covered  with  kisses,  and  smelled. 

The  love  of  certain  libertines  and  sensual  women  for  perfumes1 
indicates  a  relation  between  the  olfactory  and  sexual  senses. 

A  case  mentioned  by  Heschl  ( Wiener  Zeitschrift  f.  pract.  Heil- 
kunde,  March  22,  1861)  is  remarkable,  where  the  absence  of  both  olfac- 
tory lobes  was  accompanied  by  imperfectly  developed  genitals.  It  was 
the  case  of  a  man  aged  45,  in  all  respects  well  developed,  with  the  excep- 
tion of  the  tesiicles,  which  were  not  larger  than  beans  and  contained  no 
seminal  canals,  and  the  larynx,  which  seemed  to  be  of  feminine  dimen- 
sions. Every  trace  of  olfactory  nerves  was  wanting,  and  the  trigona 
olfactoria  and  the  furrow  on  the  under  surface  of  the  anterior  lobes 
were  absent.  The  perforations  of  the  ethmoid  plate  were  sparingly 
present,  and  occupied  by  nerveless  processes  of  the  dura  instead  of  by 
nerves.  In  the  mucous  membrane  of  the  nose  there  was  also  an  absence 
of  nerves.  Finally,  the  clearly-defined  relation  of  the  olfactory  and  sexual 
senses  in  mental  diseases  is  worthy  of  notice,  in  that  in  the  psychoses  of 

1  Comp.  Laycock,  who  ("  Nervous  Diseases  of  Women,"  1840)  found  that  ia  women 
the  love  for  musk  and  similar  perfumes  was  related  to  sexual  excitement. 


28  PSYCHOPATHIA   SEXtJALlS. 

both  sexes  dependent  on  masturbation,  as  well  as  in  insanity  due  to 
disease  of  the  sexual  organs  of  the  female,  or  during  the  climacteric,1 
olfactory  hallucinations  are  especially  frequent,  while  in  cases  where  a 
sexual  cause  is  wanting  they  are  very  infrequent. 

I  am  inclined  to  doubt 2  that  olfactory  impressions  in  man,  under  nor- 
mal conditions,  as  in  animals,  play  an  important  role  in  the  excitation  of 
the  sexual  centre.  On  account  of  the  importance  of  this  consensus  for  the 
understanding  of  pathological  cases,  it  is  necessary  here  to  thoroughly 
consider  the  relations  existing  between  the  olfactory  and  sexual  senses. 

The  sexual  sphere  of  the  cerebral  cortex  may  be  excited,  in  the 
sense  of  an  excitation  of  sexual  concepts  and  impulses,  by  processes  in 
the  generative  organs.  This  is  possible  as  a  result  of  all  conditions 
which  also  excite  the  erection-centre  by  means  of  centripetal  influence 
(stimulus  resulting  from  distension  of  the  seminal  vesicles ;  enlarged 
Graafian  follicle;  any  sensory  stimulus,  however  produced,  about  the 
genitals ;  hypersemia  and  turgescence  of  the  genitals,  especially  of  the 
erectile  tissue  of  the  corpus  cavernosum  of  the  penis  and  clitoris,  as  a 
result  of  luxurious,  sedentary  life;  plethora  abdominalis,  high  external 
temperature,  warm  beds,  clothing ;  taking  of  cantharides,  pepper,  and 
other  spices). 

Libido  sexualis  may  also  be  induced  by  stimulation  of  the  gluteal 
region  (castigation,  whipping).3 

This  fact  is  not  unimportant  for  the  understanding  of  certain  patho- 
logical manifestations.  It  sometimes  happens  that  in  boys  the  first 
excitation  of  the  sexual  instinct  is  caused  by  a  spanking,  and  they  are 
thus  incited  to  masturbation.  This  should  be  remembered  by  those  who 
have  the  care  of  children. 

On  account  of  the  dangers  to  which  this  form  of  punishment  of 
children  gives  rise,  it  would  be  better  if  parents,  teachers,  and  nurses 
were  to  avoid  it  entirely. 

Passive  flagellation  may  excite  sensuality,  as  is  shown  by  the  sects 
of  flagellants,  so  widespread  in  the  thirteenth  and  fifteenth  centuries. 
They  were  accustomed  to  whip  themselves,  partly  as  atonement  and 
partly  to  kill  the  flesh  (in  accordance  with  the  principle  of  chastity 


1  Also  in  the  insanity  of  gestation. — Trans. 

2  The  following  case,  reported  by  Binet,  seems  to  be  in  opposition  to  this  idea. 
Unfortunately  nothing  is  said  concerning  the  mental  characteristics  of  the  person.  In 
any  event,  it  is  certainly  confirmatory  of  the  relations  existing  between  the  olfactory  and 
sexual  senses  : — 

D.,  a  medical  student,  was  seated  on  a  bench  in  a  public  park,  reading  a  book  (on 
pathology) .  Suddenly  a  violent  erection  disturbed  him.  He  looked  up  and  noticed  that  a 
lady,  redolent  with  perfume,  had  taken  a  seat  upon  the  other  end  of  the  bench.  D.  could 
attribute  the  erection  to  nothing  but  the  unconscious  olfactory  impression  made  upon  him. 

3  Meibomius,  "  De  flagiorum  usu  in  re  medica,"  London,  1765 ;  Boileau,  "  The  His- 
tory of  the  Flagellants,"  London,  1783. 


PHYSIOLOGY.  29 

promulgated  by  the  Church, — i.e.,  the  emancipation  of  the  soul  from 
sensuality). 

These  sects  were  at  first  favored  by  the  Church ;  but,  since  sensu- 
ality was  only  excited  the  more  by  flagellation,  and  the  fact  became  ap- 
parent in  unpleasant  occurrences,  the  Church  was  finally  compelled  to 
oppose  it.  The  following  facts  from  the  lives  of  the  two  heroines  of 
flagellation,  Maria  Magdalena  of  Pazzi  and  Elizabeth  of  Genton,  clearly 
show  the  significance  of  flagellation  as  a  sexual  excitant.  The  former,  a 
child  of  distinguished  parents,  was  a  Carmelite  nun  in  Florence  (about 
1580),  and,  by  her  flagellations,  and,  still  more,  through  the  results  of 
them,  she  became  quite  celebrated,  and  is  mentioned  in  the  Annals.  It 
was  her  greatest  delight  to  have  the  prioress  bind  her  hands  behind  her 
and  have  her  whipped  on  the  naked  loins  in  the  presence  of  the  assembled 
sisters. 

But  the  whippings,  continued  from  her  earliest  youth,  quite  de- 
stroyed her  nervous  system,  and  perhaps  no  other  heroine  of  flagellation 
had  so  many  hallucinations  ("  Entziickungen  ").  While  being  whipped  ber 
thoughts  were  of  love.  The  inner  fire  threatened  to  consume  her,  and  she 
frequently  cried,  "  Enough !  Fan  no  longer  the  flame  that  consumes  me. 
This  is  not  the  death  I  long  for ;  it  comes  with  all  too  much  pleasure  and 
delight."  Thus  it  continued.  But  the  spirit  of  impurity  wove  the  most 
sensual,  lascivious  fancies,  and  she  was  several  times  near  losing  her 
chastity. 

It  was  the  same  with  Elizabeth  of  Genton.  As  a  result  of  whipping 
she  actually  passed  into  a  state  of  bacchanalian  madness.  As  a  rule,  she 
rested  when,  excited  by  unusual  flagellation,  she  believed  herself  united 
with  her  "  ideal."  This  condition  was  so  exquisitely  pleasant  to  her  that 
she  would  frequently  cry  out,  "  0  love,  0  eternal  love,  0  love,  0  you 
creatures !  cry  out  with  me,  love,  love !" 

It  is  known,  on  the  authority  of  Taxil  (op.  cit.,  p.  175),  that  rakes 
sometimes  have  themselves  flagellated,  or  pricked  until  blood  flows,  just 
before  the  sexual  act,  in  order  to  stimulate  their  diminished  sexual  power. 

These  facts  find  an  interesting  confirmation  in  the  following  experi- 
ences, taken  from  Paullini's  "  Flagellum  Salutis"  (1st  ed.,  1698;  repro- 
duction, Stuttgart,  1841): — 

"  There  are  some  nations,  viz.,  the  Persians  and  Russians,  where  the 
women  regard  blows  as  a  peculiar  sign  of  love  and  favor.  Strangely 
enough,  the  Russian  women  are  never  more  pleased  and  delighted  than 
when  they  receive  hard  blows  from  their  husbands,  as  John  Barclay 
relates  in  a  remarkable  narrative.  A  German,  named  Jordan,  went  to 
Russia,  and,  pleased  with  the  country,  he  settled  there  and  took  a  Russian 
wife,  whom  he  loved  dearly  and  to  whom  he  was  always  kind  in  every- 
thing. But  she  always  wore  an  expression  of  dissatisfaction,  and  went 
about  with  sighs  and  downcast  eyes.  The  husband  asked  the  reason,  for 
he  could  not  understand  what  was  wrong.     '  Aye,'  she  said,  '  though  you 


30  PSYCHOPATHIA   SEXUALIS. 

love  me  you  do  not  show  me  any  sign  of  it.'  He  embraced  her  and 
begged  to  be  told  what  he  had  carelessly  and  unconsciously  done  to  hurt 
her  feelings,  and  to  be  forgiven,  for  he  would  never  do  it  again.  '  I  want 
nothing,'  was  the  answer,  '  but  what  is  customary  in  our  country, — the 
whip,  the  real  sign  of  love.'  Jordan  observed  the  custom  and  accustomed 
himself  to  it,  and  then  his  wife  began  to  love  him  dearly.  Similar  stories 
are  told  by  Peter  Petrius,  of  Erlesund,  with  the  addition  that  the 
husbands,  immediately  after  the  wedding,  among  other  indispensable 
household  articles,  provide  themselves  with  whips." 

On  page  13  of  this  remarkable  book,  the  author  says  further :  "  The 
celebrated  Count  of  Mirindula,  John  Picus,  relates  of  one  of  his  intimate 
acquaintances  that  he  was  an  insatiable  fellow,  but  so  lazy  and  incapable 
of  love  that  he  was  practically  impotent  until  he  had  been  roughly 
handled.  The  more  he  tried  to  satisfy  his  desire,  the  heavier  the  blows 
he  needed,  and  he  could  not  attain  his  desire  until  he  had  been  whipped 
until  the  blood  came.  For  this  purpose  he  had  a  suitable  whip  made, 
which  was  placed  in  vinegar  the  day  before  using  it.  He  would  give  this 
to  his  companion  and  on  bended  knees  beg  her  not  to  spare  him,  but  to 
strike  blows  with  it,  the  heavier  the  better.  The  good  count  thought 
this  singular  man  found  the  pleasure  of  love  in  this  punishment.  While 
in  other  respects  he  was  not  a  bad  man,  he  understood  and  hated  his 
weakness.  Coelius  Rhodigin  relates  a  similar  story,  as  does  also  the 
celebrated  jurist,  Andreas  Tiraquell.  In  the  time  of  the  skillful  physician, 
Otten  Brunfelsen,  there  lived  in  Munich,  then  the  Capital  of  the  Bavarian 
Electorate,  a  debauchee  who  could  never  perform  his  [sexual]  duties 
without  a  severe  preparatory  beating.  Thomas  Barthelin  also  knew  a 
Venetian -who  had  to  be  beaten  and  driven  before  he  could  have  inter- 
course,— -just  as  Cupid  himself  moved  reluctantly  driven  by  his  followers 
with  sprays  of  hyacinth.  A  few  years  ago  there  was  in  Lubeck  a  cheese- 
monger, living  on  Mill  Street,  who,  on  a  complaint  to  the  authorities  of 
unfaithfulness,  was  ordered  to  leave  the  city.  The  prostitute  with  whom 
he  had  been  went  to  the  judges  and  begged  in  his  behalf,  telling  how  dif- 
ficult all  intercourse  had  become  for  him.  He  could  do  nothing  until  he 
had  been  mercilessly  beaten.  At  first  the  fellow,  from  shame  and  to  avoid 
disgrace,  would  not  confess,  but  after  earnest  questioning  he  could  not 
deny  it.  There  is  said  to  have  been  a  man  in  the  Netherlands  who  was 
similarly  incapable,  and  could  do  nothing  without  blows.  On  the  decree 
of  the  authorities,  however,  he  was  not  only  removed  from  his  position, 
but  also  properly  punished.  A  credible  friend,  a  physician  in  an  im- 
portant city  of  the  kingdom,  told  me,  on  July  14th,  last  year,  how  a 
woman  of  bad  character  had  told  a  companion,  who  had  been  in  the  hos- 
pital a  short  time  before,  that  she,  with  another  woman  of  like  character, 
had  been  sent  to  the  woods  by  a  man  who  followed  them  there,  cut  rods 
for  them,  and  then  exposed  his  nates,  commanding  them  to  belabor  him 
well.    This  they  did.    It  is  easy  to  conclude  what  he  then  did  with  them. 


PHYSIOLOGY.  31 

Not  only  men  have  been  excited  and  inflamed  to  lasciviousness,  but  also 
women,  that  they  too  might  experience  greater  intensity  of  pleasure. 
For  this  reason  the  Roman  woman  had  herself  whipped  and  beaten  by 
the  lupercis.     Thus  Juvenal  writes : — 

"  '  Steriles  moriuntur,  et  illis 
Turgida  non  piodest  condita  psycido  Lydc  : 
Nee  piodest  agili  palmas  praebere  Lupereo.' " 

In  men,  as  well  as  in  women,  erection  and  orgasm,  or  even  ejacu- 
lation, may  be  induced  by  irritation  of  various  other  regions  of  the  skin 
and  mucous  membrane.  These  "  erogenous  "  zones  in  woman  are,  while 
she  is  a  virgin,  the  clitoris,  and,  after  defloration,  the  vagina  and  cervix 
uteri. 

In  woman  the  nipple  particularly  seems  to  possess  this  quality. 
Titillatio  hujus  regionis  plays  an  important  part  in  the  ars  erotica.  In 
his  "  Typograpical  Anatomy,"  1865,  Bd.  i,  p.  552,  Hyrtl  cites  Val.  Hilde- 
brandt,  who  observed  a  peculiar  anomaly  of  the  sexual  instinct  in  a  girl, 
which  he  called  suctusstupratio.  She  had  her  mammae  sucked  by  her 
lover,  and  finally,  by  gradually  drawing  on  her  nipples,  she  became  able 
to  suck  them  herself, — an  act  that  gave  her  most  intense  pleasure.  Hyrtl 
also  calls  attention  to  the  fact  that  cows  sometimes  suck  the  milk  from 
their  own  udders.  L.  Brunn  (Zeitg.f.  Literatur,  etc.,  d.  Hamburg.  Cor- 
respondent, 1889,  Nr.  21),  in  an  interesting  article  on  "Sensuality  and 
Love  of  Kin,"  points  out  how  zealously  the  nursing  mother  gives  herself 
to  nursing  the  babe,  "  for  love  of  the  weak,  undeveloped,  helpless  being." 

It  is  easy  to  assume  that,  by  the  side  of  the  ethical  motives,  the  fact 
that  the  sucking  may  be  attended  by  feelings  of  physical  pleasure  plays  a 
part.  The  remark  of  Brunn,  which  is  correct  in  itself,  but  one-sided,  that, 
according  to  Houzeau's  experience,  among  the  majority  of  animals  it  is 
only  during  the  time  of  nursing  that  the  relations  between  mother  and 
offspring  are  close,  and  thereafter  indifferent,  also  speaks  in  favor  of  this 
assumption. 

Bastian  found  the  same  thing  (blunting  of  the  feeling  for  the  off- 
spring after  weaning)  among  savages. 

Under  pathological  conditions,  as  is  shown  by  Chambard,  among 
others,  in  his  thesis  for  the  doctorate,  other  portions  of  the  body  (in 
hysterical  persons)  about  the  mammae  and  genitals  may  attain  the  signifi- 
cance of  "  erogenous  "  zones. 

In  man,  physiologically,  the  only  "  erogenous  "  zone  is  the  glans 
penis,  and,  perhaps,  the  skin  of  the  external  genitals. 

Under  pathological  conditions  the  anus  may  become  an  "  erogenous  " 
area.  Thus  anal  auto-masturbation,  which  seems  to  be  only  too  frequent, 
and  passive  pederasty  would  be  explained.  (Comp.  Gamier, "  Anomalies 
sexuelles,"  Paris,  p.  514  ;  F.  Moll,  "  Contrare  Sexualempfindung,"  p.  163.) 

The  psycho-physiological  process  comprehended  in  the  idea  of  sexual 


32  PSYCHOPATHIA   SEXUALIS. 

instinct  is  composed  of  (1)  concepts  awakened  centrally  or  peripherally ; 
(2)  the  pleasurable  feelings  associated  with  them. 

The  longing  for  sexual  satisfaction  (libido  sexualis)  arises  from 
them.  This  desire  grows  stronger  constantly,  in  proportion  as  the  ex- 
citation of  the  cerebral  sphere  accentuates  the  feeling  of  pleasure  by 
appropriate  concepts  and  activity  of  the  imagination ;  and  the  pleasurable 
sensations  are  increased  to  lustful  feeling  by  excitation  of  the  erection 
centre  and  the  consequent  hyperemia  of  the  genitals  (entrance  of  liquor 
prostaticus  into  the  urethra,  etc.). 

If  circumstances  are  favorable  for  the  performance  of  the  sexual  act 
satisfactorily,  the  constantly-increasing  desire  is  complied  with ;  if,  how- 
ever, conditions  are  unfavorable,  inhibitory  concepts  occur,  overcome  the 
sexual  longing,  and  prevent  the  sexual  act. 

To  civilized  man  cultivation  of  a  readiness  with  ideas  which  inhibit 
sexual  desire  is  necessary  and  distinctive.  The  moral  freedom  of  the 
individual,  and  the  decision  whether,  under  certain  circumstances,  excess, 
and  even  crime,  be  committed  or  not,  depend,  on  the  one  hand,  upon  the 
strength  of  the  instinctive  concepts  and  the  accompanying  organic  sen- 
sations; on  the  other,  upon  the  power  of  the  inhibitory  concepts.  Con- 
stitution and,  especially,  organic  influences  have  a  marked  effect  upon 
the  instinctive  impulses ;  education  and  cultivation  of  self-control  have  a 
decisive  influence  on  the  opposing  concepts. 

The  exciting  and  inhibitory  powers  are  variable  quantities.  Over- 
indulgence in  alcohol  in  this  respect  is  very  fatal,  since  it  awakens 
and  increases  libido  sexualis,  while  at  the  same  time  it  reduces  moral 
resistance. 

The  Act  of  Cohabitation.1 

The  essential  condition  for  the  man  is  sufficient  erection.  Anjel 
(Arch,  fur  Psych.,  viii,  H.  2)  calls  attention  to  the  fact  that  in  sexual 
excitement  the  erection  centre  is  not  alone  influenced. — the  nervous  ex- 
citement is  distributed  to  the  entire  vasomotor  system  of  nerves.  The 
proof  of  this  is  the  turgescence  of  the  organs  in  the  sexual  act,  injection 
of  the  conjunctiva,  prominence  of  the  eyes,  dilatation  of  the  pupils,  and 
cardiac  palpitation  (resulting  from  paralysis  of  the  vasomotor  nerves  of 
the  heart,  which  arise  from  the  cervical  sympathetic,  and  the  consequent 
dilatation  of  the  cardiac  arteries,  and  the  increased  stimulation  of  the 
cardiac  ganglia  induced  by  the  consequent  hyperemia  of  the  cardiac 
walls).  The  sexual  act  is  accompanied  by  a  pleasurable  feeling,  which,  in 
the  male,  is  conditioned  by  the  passage  of  semen  through  the  ductus 
ejaculatorii  to  the  urethra,  caused  by  sensory  stimulation  of  the  genitals. 
The  pleasurable  sensation  occurs  earlier  in  the  male  than  in  the  female, 
grows  rapidly  in  intensity  until  the  moment  of  commencement  of  ejacu- 

1  Comp.  Roubaud,  "  Trait6  de  l'impuissance  et  de  la  st6rilit6."    Paris,  1878. 


PHYSIOLOGY.  33 

lation,  reaching  its  height  in  the  instant  of  free  emission,  and  disappears 
quickly  post  ejaculationem. 

'     In  the  female  the  pleasurable  feeling  occurs  later  and  comes  on  more 
slowly,  and  generally  outlasts  the  act  of  ejaculation. 

The  distinctive  event  in  coitus  is  ejaculation.  This  function  is  de- 
pendent on  a  centre  (genito-spinal),  which  Budge  has  shown  to  be  situated 
at  the  level  of  the  fourth  lumbar  vertebra.  It  is  a  reflex  centre.  The 
stimulus  that  excites  it  is  the  ejection  of  sperma  from  the  vesiculoe  semi- 
nales  into  the  pars  membranacea  urethra?,  which  follows  reflexly  from 
stimulation  of  the  glans  penis.  As  soon  as  the  collection  of  semen,  with 
ever-increasing  pleasurable  sensation,  has  reached  a  sufficient  amount  to 
be  effectual  as  a  stimulus  of  the  ejaculation-centre,  the  centre  acts.  The 
reflex  motor  path  lies  in  the  fourth  and  fifth  lumbar  nerves.  The  action 
consists  of  a  convulsive  excitation  of  the  bulbo-cavernosus  muscle  (inner- 
vated by  the  third  and  fourth  sacral  nerves),  which  forces  the  semen  out. 

In  the  female  as  well,  at  the  height  of  sexual  and  pleasurable  ex- 
citement, a  reflex  movement  occurs.  It  is  induced  by  stimulation  of  the 
sensory  genital  nerves,  and  consists  of  a  peristaltic  movement  in  the  tubes 
and  uterus  as  far  down  as  the  portio  vaginalis,  which  presses  out  the 
mucous  secretions  of  the  tubes  and  uterus.  Inhibition  of  the  ejaculation 
centre  is  possible  as  a  result  of  cortical  influence  (want  of  desire  in  coitus, 
emotions  in  general ;  influence  of  the  will,  in  a  measure). 

Under  normal  conditions,  with  the  completion  of  the  sexual  act, 
libido  sexualis  and  erection  disappear,  and  the  psychical  and  sexual 
excitement  gives  place  to  a  comfortable  feeling  of  lassitude. 


III.    GENERAL  PATHOLOGY.1 


(NEUROLOGICAL  AND  PSYCHOLOGICAL.) 


Abnormality  of  the  sexual  functions  proves  to  be  especially 
frequent  in  civilized  races.  This  fact  is  explained  in  part  by  the 
frequent  abuse  of  the  sexual  organs,  and  in  part  by  the  circum- 
stance that  such  functional  anomalies  are  often  the  signs  of  an 
abnormal  constitution  of  the  central  nervous  system,  which  is,  for 
the  most  part,  hereditary  ("  functional  signs  of  degeneration  "). 

Since  the  generative  organs  stand  in  important  functional 
connection  with  the  entire  nervous  system,  and  especially  with 
its  psychical  and  somatic  functions,  it  is  easy  to  understand  the 
frequency  of  general  neuroses  and  psychoses  arising  in  sexual 
(functional  or  organic)  disturbances. 

Schema  op  the  Sexual  Neuroses. 
a.  Anaesthesia. 


1.  Sensory. 


I.  Peripheral.2  < 


II.  Spinal. 


III.  Cerebral. 


2.  Secretory. 

3.  Motor. 


b.  Hyperesthesia. 

c.  Neuralgia. 

a.  Aspermia. 

b.  Polyspermia. 

a.  Pollutions  (spasm). 

b.  Spermatorrhoea  (paralysis). 

(  1.  Affections  of  the  erection  centre. 
(  2.  Affections  of  the  ejaculation  centre. 

1.  Paradoxia. 

2.  Anaesthesia. 

3.  Hyperaesthesia. 

4.  Paraesthesia. 


1  Literature  :  Parent-Duchatelet,  Prostitution  dans  la  ville  de  Paris,  1837. — Rosen- 
baum,  Entstehung  der  Syphilis,  Halle,  1839 ;  also,  Die  Lustseuche  im  Alterthum,  Halle, 
1839. — Descuret,  La  m6decine  des  passions,  Paris,  1860. — Casper,  Klin.  Novellen,  1863. — 
Bastian,  Der  Menseh  in  der  Geschichte. — Friedlander,  Sittengeschichte  Roms. — Wiede- 
ineister,  Casarenwahnsinn. — Scherr,  Deutsche  Cultur-  und  Sittenge-  schichte,  Bd.  i,  Cap.  9. 
— Tardieu,  Des  attentats  aux  moeurs.,  7  6dit.,  1878. — Emminghaus,  Psychopathol.,  pp.  98, 
225,  230,  232. — Schiile,Handbuch  der  Geisteskrankheiten,  p.  114. — Marc,  Die  Geisteskrank- 
heiten,  ubers  v.  Ideler,  ii,  p.  128. — v.  Krafft,  Lehrb.  der  Psychiatrie,  4  Aufl.,  i,  p.  90 ;  Lehrb. 
d.  ger.  Psychopathol.,  2  Aufl.,  p.  234;  Archiv  f.  Psychiatrie,  vii,  2. — Moreau,  Des  aberra- 
tions du  sens  g6nesique,  Paris,  1880. — Kirn,  Allg.  Zeitschr.  f.  Psychiatrie,  xxxix,  Heft  2 
u.  3. — Lombroso,  Geschlechtstrieb  u.  Verbrechen  in  ihren  gegenseitigen  Beziehungen 
(Goltdammer's  Archiv,  Bd.  xxx.). — Tarnowsky,  Die  krankhaften  Erscheinungen  des 
Geschlechtssinns,  Berlin,  1886. — Ball,  La  Folie  6rotique,  Paris,  1888. — Serieux,  Recherches 
cliniques sur  les  anomalies  de  l'instinctsexuel,  Paris,  18S8. — Hammond,  Sexual  Impotence. 

2  Vide  Ultzmann,  Genito-Urinary  Neuroses  in  the  Male  (published  by  The  F.  A. 
Davis  Co.,  Philadelphia),  for  discussion  of  peripheral  neuroses. 


(34) 


GENERAL  PATHOLOGY.  35 

II.  SPINAL  NEUROSES. 

1.  Affections  of  the  Erection  Centre. 

(a)  Irritation  (priapism)  arises  reflexly  from  peripheral  sensory 
irritants  (e.g.,  gonorrhoea) ;  directly,  from  organic  irritation  of  the  nerve- 
tracts  from  the  brain  to  the  erection  centre  (spinal  disease  in  the  lower 
cervical  and  upper  dorsal  regions),  or  of  the  centre  itself  (certain  poisons) ; 
or  from  psychical  irritation.  In  the  latter  case  satyriasis  exists,  i.e.,  ab- 
normal duration  of  erection,  with  libido  sexualis.  In  simply  reflex  or 
direct  organic  irritation,  libido  sexualis  may  be  wanting,  and  the  priapism 
be  accompanied  by  unpleasant  feelings. 

(b)  Paralysis  from  destruction  of  the  centre  or  of  the  nerve-tracts 
(nervi  erigentes),  in  diseases  of  the  spinal  cord  (paralytic  impotence). 
A  milder  form  is  that  of  lessened  excitability  of  the  centre,  resulting 
from  overstimulation  (in  sexual  excesses,  especially  in  onanism),  or  from 
alcoholic  intoxication,  abuse  of  bromides,  etc.  It  may  be  accompanied 
by  cerebral  anaesthesia,  and  often  with  anaesthesia  of  the  external  genitals. 
Cerebral  hyperesthesia  is  here  more  frequent  (increased  libido  sexualis, 
lust).  A  peculiar  form  of  diminished  excitability  is  shown  in  those 
cases  where  the  centre  responds  only  to  certain  stimuli.  Thus  there  are 
men  for  whom  sexual  contact  with  their  virtuous  wives  does  not  supply 
the  necessary  stimulus  for  the  excitation  of  an  erection,  but  in  whom  it 
occurs  when  the  act  is  attempted  with  a  prostitute,  or  in  the  form  of 
some  unnatural  sexual  act.  As  far  as  psychical  stimuli  are  here  con- 
cerned, they  may  be  inadequate  (v.  infra,  paresthesia  and  perversion  of 
sexual  instinct). 

(c)  Inhibition.  The  erection  centre  may  become  functionally  inca- 
pable as  a  result  of  cerebral  influence.  This  inhibitory  influence  is  an 
emotion  (disgust,  fear  of  contagion),  or  an  idea1  of  impotence.  There 
are  many  men  in  the  first  condition  who  have  an  unconquerable  loathing 
for  their  wives,  or  fear  of  infection,  or  are  suffering  with  perverse  sexual 
feelings.  In  the  latter  condition  are  neuropathic  individuals  (neuras- 
thenics, hypochondriacs),  frequently  weakened  sexually  (masturbators), 
who  have  reason,  or  think  they  have,  to  mistrust  their  sexual  power. 
This  idea  acts  as  an  inhibitory  concept,  and  makes  the  act  with  the  per- 
son concerned  of  the  opposite  sex  temporarily  or  absolutely  impossible. 

(d)  Irritable  weakness.  In  this  condition  there  is  abnormal  im- 
pressionability of  the  centre,  but  accompanied  by  rapid  diminution  of  its 
energy.  There  may  be  functional  disturbance  of  the  centre  itself,  or  weak- 
ness of  the  innervation  through  the  nervi  erigentes ;   or  there  may  be 

1  An  interesting  example  of  how  an  imperative  conception  of  non-sexual  content 
can  exert  an  influence  is  related  by  Magnan  (Ann.  m6d.  psych.,  1885)  :  Student,  aged  21, 
strongly  predisposed  hereditarily,  previously  a  masturbator,  constantly  struggles  with  the 
number  13  as  an  imperative  conception.  As  soon  as  he  attempts  coitus  the  imperative 
idea  inhibits  erection  and  makes  the  act  impossible. 


36  PSYCHOPATHIA   SEXUALIS. 

weakness  of  the  ischio-cavernosus  muscle.  Cases  in  which  the  erection 
is  ineffectual,  on  account  of  abnormally  early  ejaculation,  form  a  transition 
to  the  following  anomalies  : — 

2.  Affections  of  the  Ejaculation  Centre. 

(a)  Abnormally  easy  ejaculation  from  absence  of  cerebral  inhibi- 
tion, resulting  from  excessive  psychical  excitement  or  irritable  weakness 
of  the  centre.  In  this  case,  under  certain  circumstances,  the  simple  con- 
ception of  a  lascivious  situation  is  sufficient  to  set  the  centre  in  action 
(high  degree  of  spinal  neurasthenia,  usually  resulting  from  sexual  abuse). 
A  third  possibility  is  hyperesthesia  of  the  urethra,  by  virtue  of  which, 
when  the  semen  enters  it,  an  immediate  and  excessive  reflex  action  of 
the  ejaculation  centre  is  induced.  In  such  a  case,  simple  proximity  to 
the  female  genitals  may  be  sufficient  to  induce  ejaculation  {ante  portam). 

In  case  of  hyperesthesia  of  the  urethra  as  a  cause,  the  ejacula- 
tion may  be  accompanied  by  painful,  instead  of  pleasurable,  sensations. 
Usually,  in  cases  where  there  is  hyperesthesia  of  the  urethra,  there 
is,  at  the  same  time,  irritable  weakness  of  the  centre.  Both  functional 
disturbances  are  important  in  the  production  of  pollutio  nimia  and  cliurna. 

The  accompanying  pleasurable  feeling  may  be  pathologically  ab- 
sent. This  occurs  in  defective  men  and  women  (anesthesia,  aspermia?), 
and,  further,  as  a  result  of  disease  (neurasthenia,  listeria) ;  or  (in  pros- 
titutes) it  follows  overstimulation  and  the  blunting  thus  induced.  The 
intensity  of  the  pleasurable  feeling  depends  on  the  degree  of  psychical 
and  motor  excitement  accompanying  the  sexual  act.  Under  pathological 
conditions  this  may  become  so  pronounced  that  the  movements  of  coitus 
take  on  the  character  of  involuntary  convulsive  movements,  and  even 
pass  into  general  convulsions. 

(b)  Abnormally  difficult  ejaculation.  It  is  occasioned  by  inexcita- 
bility  of  the  centre  (absence  of  libido,  paralysis  of  the  centre :  organic, 
from  disease  of  brain  or  spinal  cord ;  functional,  from  sexual  abuses, 
marasmus,  diabetes,  morphinism),  and,  in  this  case,  for  the  most  part, 
in  connection  with  anesthesia  of  the  genitals  and  paralysis  of  the 
erection  centre.  Or  it  is  the  result  of  a  lesion  of  the  reflex  arc,  or 
of  peripheral  anesthesia  (urethra),  or  of  aspermia.  The  ejaculation 
occurs  not  at  all,  or  tardily,  in  the  course  of  the  sexual  act,  or  only 
afterward,  in  the  form  of  a  pollution. 

III.  CEREBRAL  NEUROSES. 

1.  Paradoxia,  i.e.,  sexual  excitement  occurring  independ- 
ently of  the  period  of  the  physiological  processes  in  the 
generative  organs. 

2.  Anaesthesia    (absence    of    sexual   instinct).      Here   all 


GENERAL   PATHOLOGY.  37 

organic  impulses  arising  in  the  sexual  organs,  as  well  as  all 
concepts,  and  visual,  auditory,  and  olfactory  sense-impressions, 
fail  to  excite  the  individual  sexually.  This  is  physiological  in 
childhood  and  old  age. 

3.  Hypercesthesia  (increased  desire^  satyriasis).  In  this 
state  there  is  an  abnormally  increased  impressionability  of 
the  vita  sexualis  to  organic,  psychical,  and  sensory  stimuli 
(abnormally  intense  libido,  lustfulness,  lasciviousness).  The 
stimulus  may  be  central  (nymphomania,  satyriasis)  or  periph- 
eral,   functional    or  organic. 

4.  Paresthesia  (perversion  of  the  sexual  instinct,  i.e., 
excitability  of  the  sexual  functions  to  inadequate  stimuli). 

These  cerebral  anomalies  fall  within  the  domain  of  psycho- 
pathology.  The  spinal  and  peripheral  anomalies  may  occur 
in  combination  with  them,  but  these  affect  persons,  as  a  rule, 
that  are  free  from  mental  disease.  They  may  occur  in  various 
combinations,  and  become  the  cause  of  sexual  crimes.  For  this 
reason,  they  demand  consideration  in  the  following  description. 
However,  the  cerebral  anomalies  claim  the  principal  interest, 
since  they  very  frequently  lead  to  the  commission  of  perverse 
and  even  criminal  acts. 

A.  Paradoxia.     Sexual  Instinct  Manifesting  itself   Independently 
of  Physiological  Processes. 
1.  Sexual  Instinct  Manifested  in   Childhood. 
Every  physician  conversant  with    nervous  affections   and 
diseases  incident  to  childhood  is  aware  of  the  fact  that  mani- 
festation of  sexual  instinct  may  occur  in  very  young  children. 
The    observations    of   Ultzmann    concerning    masturbation    in 
childhood1   are   worthy  of  attention    in    relation  to  it.     It  is 
necessary  here   to   differentiate   between    the   numerous   cases 
where,  as  a  result  of  phimosis,  balanitis,  or  oxyuris  in  rectum 
or  vagina,  young  children  have  itching  of  the  genitals,  and  ex- 
perience a  kind  of  pleasurable   sensation   from  manipulations 

1  Louyer-Villermay  speaks  of  masturbation  in  a  girl  of  3  or  4  years,  and  Moreau 
("Aberrations  du  sens  gcnesique,"  2  edit.,  p.  209)  of  the  same  in  one  of  2  years.  See, 
further,  Maudsley,  "  Physiology  and  Pathology  of  Mind;"  Hirschsprung  (Kopenhagen), 
Berlin,  klin.  Wochenschr. ,  1866,  Nr.  38 ;  Lombroso,  "  The  Criminal,"  Cases  10, 19,  and  21. 


38  PSYCHOPATHIA   SEXUALIS. 

thus  induced,  and  thus  come  to  practice  masturbation;  and 
those  cases  in  which  sexual  ideas  and  impulses  occur  in  the 
child  as  a  result  of  cerebral  processes  without  peripheral  causes. 
It  is  only  in  this  latter  class  of  cases  that  we  have  to  do  with 
the  early  manifestation  of  sexual  instinct.  In  such  cases  it  may 
always  be  regarded  as  an  accompanying  symptom  of  a  neuro- 
psychopathic constitutional  condition.  A  case  of  Marc's  ("Die 
Geisteskrankheiten,"  etc.,  von  Ideler,  i,  p.  66)  illustrates  very 
well  these  conditions.  The  subject  was  a  girl  of  eight  years, 
of  respectable  family,  who  was  devoid  of  all  child-like  and  moral 
feelings,  and  had  masturbated  from  her  fourth  year;  at  the 
same  time  she  consorted  with  boys  of  the  age  of  ten  or  twelve. 
She  had  thought  of  killing  her  parents,  that  she  might  become 
her  own  mistress  and  give  herself  up  to  pleasure  with  men.  In 
these  cases  of  early  manifestation  of  libido  the  children  come  also 
to  masturbate ;  and,  since  they  are  greatly  predisposed  constitu- 
tionally, they  frequently  sink  into  dementia,  or  become  subjects 
of  severe  degenerative  neuroses  or  psychoses. 

Lombroso  (Archiv  di  Psichiatria,  iv,  p.  22)  has  collected  a  number 
of  cases  of  children  affected  with  very  decided  hereditary  taint,  which 
belong  in  this  category.  One  was  that  of  a  girl  who  masturbated  shame- 
lessly and  almost  constantly  at  the  age  of  three.  Another  girl  began  at 
the  age  of  eight,  and  continued  to  practice  masturbation  when  married, 
and  even  during  pregnancy.  She  was  pregnant  twelve  times.  Five  of 
the  children  died  early,  four  were  hydrocephalic,  and  two  boys  began  to 
masturbate, — one  at  the  age  of  seven,  the  other  at  the  age  of  four. 

Zambaco  (VEncephale,  1882,  Nr.  1,  2)  tells  the  disgusting  story  of 
two  sisters  affected  with  premature  and  perverse  sexual  desire.  The  elder, 
R.,  masturbated  at  the  age  of  seven,  practiced  lewdness  with  boj-s,  stole 
wherever  she  could,  seduced  her  four-year-old  sister  into  masturbation,  and 
at  the  age  of  ten  was  given  up  to  the  practice  of  the  most  revolting  vices. 
Even  ferrum  candens  ad  clitoridem  had  no  effect  in  overcoming  the 
practice,  and  she  masturbated  with  the  cassock  of  a  priest  while  he  was 
exhorting  her  to  reformation. 

2.  Re-awakening  of  Sexual  Instinct  in   Old  Age.1 
There  are  infrequent  cases  in  which  the  sexual  instinct  per- 
sists until  a  great  age.    "Senectus  non  quidcm  annis  sed  viribus 

1  Comp.  Kirn,  Zeitschr.  f.  Psych.,  Bd.  xxxix.  Legrand  du  Saulle,  Annal.  d'hyg., 
1868,  Oct. 


GENERAL  PATHOLOGY.  39 

magis  sestimatur"  (Zittraann).  Oesterlen  (Maschka,  Handb., 
iii,  p.  18)  mentions  the  case  of  a  man  aged  83,  who  was  sentenced 
to  three  years'  imprisonment  by  a  Wurtemberg  court  on  account 
of  sexual  misdemeanors.  Unfortunately  nothing  is  said  of  the 
nature  of  the  crime  or  of  the  mental  condition  of  the  criminal. 1 

The  manifestation  of  sexual  instinct  in  old  age  is  not  in 
itself  pathological ;  but  presumption  of  pathological  conditions 
must  necessarily  be  entertained  when  the  individual  is  decrepit 
and  his  sexual  life  has  already  long  become  extinct;  and  when 
the  impulse,  in  a  man  whose  sexual  needs  were  in  his  early 
life,  perhaps,  not  very  marked,  manifests  itself  with  greater 
strength,  and  strives  for  even  perverse  satisfaction  in  a  shame- 
less and  impulsive  manner.  In  such  cases  there  is  at  once 
suggested  a  presumption  of  pathological  conditions.  Medical 
science  recognizes  the  fact  that  such  an  impulse  depends  upon 
the  morbid  alterations  of  the  brain  which  lead  to  senile  dementia. 
This  abnormal  manifestation  of  sexual  life  may  be  the  precursor 
of  senile  dementia,  and  make  its  appearance  even  long  before 
there  are  any  well-defined  manifestations  of  intellectual  weak- 
ness. The  attentive  and  experienced  observer  will  always  be 
able  to  detect  in  this  prodromal  stage  an  alteration  of  character 
in  pejus,  and  a  deterioration  of  the  moral  sense  accompanying 
the  peculiar  sexual  manifestation. 

The  libido  of  those  passing  into  senile  dementia  is  at  first 
expressed  in  lascivious  speech  and  gesture.  The  next  objects 
of  the  attempts  of  these  senile  subjects  of  brain  atrophy  and 
psychical  degeneration  are  children.  This  sad  and  dangerous 
fact  is  explained  by  the  better  opportunity  they  have  of  falling 
in  with  children,  but  more  especially  by  a  feeling  of  imperfect 
sexual  power.  Defective  sexual  power  and  greatly  diminished 
moral  sense  explain  the  additional  fact  of  the  perversity  of  the 

1The  translator  has  lately  seen  a  case  of  this  kind  that  illustrates  the  lack  of  care 
taken  hy  our  criminal  courts.  A  very  infirm  man.  aged  55  to  60,  under  favoring  circum- 
stances, made  an  unsuccessful  sexual  assault  on  a  girl  aged  about  18.  At  his  trial  he  made 
full  confession,  and  explained  his  act  as  due  to  ordinary  sinfulness.  He  was  the  father  of 
a  family  and  living  with  his  wife,  and  up  to  that  time  blameless  sexually.  He  was  sentenced 
to  five  years  of  hard  labor  !  He  was  incapable  of  almost  the  lightest  work.  Conversation 
with  him  while  in  jail  showed  at  once  that  he  was  well  advanced  in  senile  dementia.  Legal 
question  concerning  his  mental  condition  was  not  raised, — because  he  confessed,  probably  ! 


40  PSYCHOPATHIA   SEXUALIS. 

sexual  acts  of  these  aged  men.  They  are  the  equivalents  of  the 
impossible  physiological  act. 

The  annals  of  legal  medicine  distinguish,  as  such,  exhibition 
of  the  genitals,1  lustful  handling  of  the  genitals  of  children,2 
inducing  them  to  perform  manustupration  of  the  seducer,  and 
performing  masturbation3  or  flagellation  on  the  victim. 

In  this  stage  the  intellect  may  still  be  sufficiently  intact  to 
allow  avoidance  of  publicity  and  discovery,  while  the  moral  sense 
is  too  far  gone  to  allow  consideration  of  the  moral  significance 
of  the  act  and  resistance  to  the  impulse.  With  the  progress  of 
dementia,  these  acts  are  more  and  more  shamelessly  committed. 
Then  care  on  account  of  defective  sexual  power  disappears,  and 
adults  also  become  the  objects  of  the  senile  passion ;  but  the 
defective  sexual  power  necessitates  equivalents  for  coitus.  Not 
infrequently  sodomy  results,  and,  as  Tarnowsky  (op.  tit,  p.  77) 
points  out,  in  the  sexual  act  performed  with  geese,  chickens, 
etc.,  the  sight  of  the  dying  animal  and  its  death-struggles  at  the 
time  of  coitus  afford  complete  satisfaction.  The  perverse  sexual 
acts  with  adults  are  quite  as  horrible,  and  may  be  explained 
psychologically  in  the  same  way. 

Case  49,  in  the  author's  "Text-Book  of  Legal  Psycho- 
pathology,"  second  ed.,  p.  161,  demonstrates  how  enormously 
increased  sexual  lust  may  be  during  the  course  of  senile 
dementia.  Quum  senex  libidinosus  germanam  suam  filiam 
semulatione  motus  necaret  et  adspectu  pectoris  sciosi  puellaB 
moribundae  delectaretur. 

Erotic  delirium  and  states  of  satyriasis  may  occur,  in  the 
course  of  the  malady,  with  or  without  maniacal  episodes,  as 
the  following  case  shows: — 

Case  1.  J.  Rene,  always  given  to  indulgence  in  sensualit}'  and  sexual 
pleasures,  but  always  with  regard  for  decorum,  has  shown,  since  his 
seventy-sixth  year,  a  progressive  loss  of  intelligence  and  increasing  per- 
version of  his  moral  sense.  Previously  bright  and  outwardly  moral,  he 
now  wasted  his  property  in  concourse  with  prostitutes,  frequented  brothels 

1  Cases,  vide  Lasegue  :  "  Les  exhibitionistes,"  Union  m6dicale,  1877,  May  1st. 

2  Legraud  du  Saulle,  La  folie  devant  les  tribunaux.  p.  530. 

8  Kirn,  Maschka's  Haudb.  d.  ger.  Med.,  pp.  373, 374 ;  Allg.  Zeitschrift  f.  Psychiatric, 
Bd.  xxxix,  p.  220. 


GENERAL   PATHOLOGY.  41 

only,  asked  every  woman  on  the  street  to  marry  him  or  allow  coitus,  and 
thus  became  so  publicly  obnoxious  that  it  was  necessary  to  place  him  in 
an  asylum.  There  the  sexual  excitement  increased  to  a  veritable  saty- 
riasis, which  lasted  until  he  died.  He  masturbated  continuously,  even 
before  others  ;  took  delight  only  in  obscene  ideas  ;  thought  the  men  about 
him  were  women,  and  followed  them  with  indecent  proposals  (Legrand  du 
Saulle,  "  La  Folie,"  p.  533). 

Moreover,  women  previously  moral,  when  affected  with  senile  de- 
mentia, may  manifest  similar  conditions  of  great  sexual  excitement 
(nymphomania,  furor  uterinus). 

It  may  be  seen  from  a  reading  of  Schopenhauer,1  that,  as 
a  result  of  senile  dementia,  the  abnormally  excited  and  perverse 
instinct  may  be  directed  exclusively  to  persons  of  the  same  sex 
(v.  infra).  The  manner  of  the  satisfaction  is  here  passive 
pederasty,  or,  as  I  ascertained  in  the  following  case,  mutual 
masturbation : — 

Case  2.  Mr.  X.,aged  80,  of  high  social  position,  from  a  family  hav- 
ing hereditary  taint.  He  was  always  very  sensual  and  a  cynic,  of  uncon- 
trollable temper,  and,  according  to  his  own  confession,  as  a  young  man, 
preferred  masturbation  to  coitus.  However,  he  never  showed  signs  of 
contrary  sexual  instinct,  and  kept  mistresses,  raising  a  child  by  one.  At 
the  age  of  forty-eight  he  married,  out  of  inclination,  and  begat  six  chil- 
dren, and  never  gave  his  wife  cause  for  complaint.  I  could  obtain  but  an 
incomplete  history  of  his  family.  It  was  certain  that  his  brother  was 
suspected  of  love  for  men,  and  that  a  nephew  became  insane  as  a  result 
of  excessive  masturbation. 

The  patient,  always  peculiar  and  quick-tempered,  for  years  has  been 
growing  more  extreme  in  character.  He  has  become  exceedingly  sus- 
picious, and  slight  opposition  to  his  wishes  induces  attacks  of  anger 
which  may  become  actual  raving,  and  in  which  he  may  raise  his  hand 
against  his  wife.  For  a  year  there  have  been  unmistakable  signs  of  in- 
cipient senile  dementia.  The  patient  has  become  forgetful,  localizes  past 
events  incorrectly,  and  has  false  ideas  of  time.  For  fourteen  months  it 
has  been  noticed  that  he  manifests  affection  for  certain  male  servants, 
especially  for  a  gardener's  boy.  Otherwise  rude  and  overbearing  to 
servants,  he  surfeits  his  favorite  with  favors  and  presents,  and  commands 
his  family  and  his  house  officials  to  treat  the  boy  with  the  greatest 
respect.  The  aged  patient  awaits  the  hour  of  rendezvous  in  true  sexual 
excitement.  He  sends  his  family  away,  that  he  may  be  with  his  favorite 
undisturbed,  and  remains  shut  up  with  him  for  hours  ;   and  when  the 

1  Die  Welt  als  Wille  und  Vorstellung,  1859,  B.  ii,  p.  461  et  seq. 


42  PSYCHOPATHIA   SEXUALIS. 

doors  are  opened  again,  he  is  found  lying  on  the  bed  exhausted.  Besides 
this  object  of  his  passion,  the  patient  had  intercourse  episodically  with 
other  servants.  It  is  certain  that  he  enticed  them,  asked  them  for  kisses, 
exhibited  himself,  allowed  manipulation  ad  genitalia,  and  practiced  mutual 
masturbation.  By  these  practices  absolute  demoralization  was  brought 
about.  The  family  was  powerless ;  for  any  opposition  caused  violent 
outbreaks  of  anger  and  even  threats  against  his  relatives.  The  patient 
was  completely  without  appreciation  of  his  perverse  sexual  acts;  and 
therefore  the  only  course  left  to  the  afflicted  family  was  to  remove  all 
authority  from  his  hands  and  place  him  in  an  asylum.  No  erotic  inclina- 
tion toward  the  opposite  sex  was  observed,  though  the  patient  occupied  a 
sleeping-apartment  with  his  wife.  With  reference  to  the  perverse  sexu- 
ality and  the  defective  moral  sense  of  this  unfortunate  man,  it  is  worthy 
of  note  that  he  questioned  the  servants  of  his  daughter-in-law  as  to 
whether  she  had  a  lover. 

B.  Anesthesia  Sexualis  (Absence  op  Sexual  Feeling). 

1.  As  a  Congenital  Anomaly. 
Only  those  cases  can  be  regarded  as  unquestionable  exam- 
ples of  absence  of  sexual  instinct  dependent  on  cerebral  causes, 
in  which,  in  spite  of  generative  organs  normally  developed  and 
the  performance  of  their  functions  (secretion  of  semen,  menstrua- 
tion), the  corresponding  emotions  of  sexual  life  are  absolutely 
wanting.  These  functionally  sexless  individuals  are  seldom  seen, 
and  are,  indeed,  always  persons  having  degenerative  defects, 
and  in  whom  other  functional  cerebral  disturbances,  states  of 
psychical  degeneration,  and  even  anatomical  signs  of  degenera- 
tion, are  observed.  Legrand  du  Saulle  describes  a  classical  case 
that  falls  under  this  head  (Annates  medico-psychol.,  May,  1876). 

Case  3.  D.,  aged  33,  had  a  mother  who  suffered  with  insanity  of 
persecution.  The  mother's  father  also  suffered  with  persecutory  insanity, 
and  committed  suicide.  Her  mother  was  insane,  and  this  woman's  mother 
became  insane  in  the  puerperal  state.  Three  of  her  mother's  children 
died  in  babj^hood,  and  those  that  lived  longer  had  an  abnormal  character. 
As  early  as  his  thirteenth  year,  D.  was  troubled  with  the  thought  of  be- 
coming insane.  At  fourteen  he  attempted  suicide.  Later,  vagabondage, 
and,  as  a  soldier,  repeated  insubordination  and  crazy  pranks.  His  intel- 
ligence was  very  limited ;  no  sign  of  degeneration,  genitals  normal.  At 
seventeen  or  eighteen  he  had  emissions  of  semen,  had  never  masturbated 
or  had  sexual  feeling,  and  never  had  sought  intercourse  with  women. 

Case  4.  P.,  aged  36,  common  laborer,  was  received  at  my  clinic  in 


GENERAL   PATHOLOGY.  43 

the  beginning  of  November  on  account  of  spastic  spinal  paralysis.  He 
declares  he  comes  of  a  healthy  family.  A  stutterer  from  his  youth. 
Cranium  microcephalic  (cf.  53  cm.).  Patient  somewhat  imbecile.  He  was 
never  sociable,  never  had  a  sexual  emotion.  The  sight  of  a  woman  never 
had  anything  enticing  for  him.  He  never  had  a  desire  to  masturbate. 
Erections  frequent,  but  only  on  waking  in  the  morning  with  a  full  bladder, 
and  without  a  trace  of  sexual  feeling.  Pollutions  very  infrequent, — about 
once  a  year,  in  sleep, — and  usually  while  dreaming  that  he  is  concerned 
with  a  female.  These  dreams,  however,  as  his  dreams  in  general,  are  not 
markedly  erotic.  He  says  the  act  of  pollution  is  not  accompanied  by  anjr 
pleasurable  sensation.  Patient  does  not  feel  this  absence  of  sexual  sensa- 
tions. He  gives  the  assurance  that  his  brother,  aged  34,  is  in  exactly  the 
same  sexual  condition  as  himself,  and  he  makes  it  seem  probable  that  a 
sister,  aged  21,  is  in  a  similar  state.  A  younger  brother,  he  says,  is  normal 
sexually.  The  examination  of  his  genitals  reveals  nothing  abnormal 
besides  phimosis. 

Hammond  ("Sexual  Impotence"),  even  with  his  wide  ex- 
perience, reports  only  the  following  three  cases  of  anaesthesia 
sexualis : — 

Case  5.  Mr.  W.,  aged  33  ;  strong,  healthy,  with  normal  genitals.  He 
had  never  experienced  libido,  and  had  vainly  sought  to  awaken  his  de- 
fective sexual  instinct  by  means  of  obscene  stories  and  intercourse  with 
prostitutes.  On  the  occasion  of  such  attempts  he  experienced  only  dis- 
gust, with  eAren  a  feeling  of  nausea,  and  became  nervously  and  mentally 
exhausted.  Only  once,  when  he  forced  the  situation,  did  he  have  a  tran- 
sitory erection.  W.  had  never  masturbated,  and  had  had  pollutions  about 
once  every  two  months  fr6m  his  seventeenth  year.  Important  interests 
demanded  that  he  many.  He  had  no  horror  feminse,  and  longed  for  a 
home  and  a  wife,  but  felt  that  he  was  incapable  of  the  sexual  act.  He 
died,  unmarried,  in  the  American  civil  war. 

Case  6.  X.,  aged  27  ;  genitals  normal ;  never  felt  libido.  Mechanical 
or  thermic  stimuli  easily  induced  erection,  but  instead  of  libido  sexualis 
there  was  regularly  a  desire  for  alcoholic  indulgence.  Such  excesses  also 
induced  erections,  and  he  then  sometimes  masturbated.  He  had  a  dis- 
inclination for  women  and  a  loathing  of  coitus.  If,  with  an  erection,  he 
made  an  attempt  at  coitus,  it  disappeared  at  once.  Death  in  coma  during 
an  attack  of  cerebral  hyperemia. 

Case  7.  Mrs.  O.,  normally  developed,  healthy,  menstruated  regu- 
larly; aged  35,  fifteen  j^ears  married.  She  never  experienced  libido,  and 
never  had  any  erotic  excitement  in  sexual  intercourse  with  her  husband. 
She  was  not  averse  to  coitus,  and  sometimes  seemed  to  experience  pleasure 
in  it,  but  she  never  had  a  wish  for  repetition  of  cohabitation. 


44  PSYCHOPATHIA   SEXUALIS. 

In  connection  with  such  pure  cases  of  anaesthesia  there 
should  be  considered  other  cases  in  which  the  mental  side  of 
the  vita  sexualis  is  a  blank  leaf  in  the  life  of  the  individual, 
but  where  elementary  sexual  sensations  manifest  themselves  at 
least  in  masturbation  (comp.  the  transitional  Case  6).  According 
to  Magnan's  ingenious  classification,  which,  however,  is  not 
strictly  correct  and  somewhat  too  dogmatic,  in  such  cases  the 
sexual  life  is  so  limited  as  to  be  designated  spinal.  Possibly  in 
some  such  cases  there  exists  virtually  a  mental  side  of  the  vita 
sexualis,  but  it  is  very  weak,  and  undermined  by  masturbation 
before  it  attains  development.  These  represent  the  transitional 
cases  from  the  congenital  to  the  acquired  (psychical)  anaesthesia 
sexualis.  This  danger  threatens  many  masturbators  of  vicious 
constitution.  It  is  psychologically  interesting  that  when  the 
sexual  element  is  early  vitiated,  then  an  ethical  defect  is  mani- 
fested. 

The  two  following  cases,  previously  published  by  me  in 
the  ArcMv  fur  Psychiatrie,  vii,  are  given  here  as  illustrations 
worthy  of  consideration  : — 

Case  8.  F.  J.,  aged  19,  student ;  mother  was  nervous,  sister  epileptic. 
At  the  age  of  four,  acute  brain  affection,  lasting  two  weeks.  As  a  child 
he  was  not  affectionate,  and  was  cold  toward  his  parents ;  as  a  student  he 
was  peculiar,  retiring,  preoccupied  with  self,  and  given  to  much  reading. 
Well  endowed  mentally.  Masturbation  from  fifteenth  year.  Eccentric 
after  puberty,  with  continual  alternation  between  religious  enthusiasm  and 
materialism, — now  stud}ing  theology,  now  natural  sciences.  At  the  uni- 
versity his  fellow-students  took  him  for  a  fool.  He  read  Jean  Paul  almost 
exclusively,  and  wasted  his  time.  Absolute  absence  of  sexual  feeling 
toward  the  opposite  sex.  Once  he  indulged  in  intercourse,  experienced 
no  sexual  feeling  in  the  act,  found  coitus  absurd,  and  did  not  repeat  it. 
Without  any  emotional  cause  whatever,  he  often  had  a  thought  of  suicide. 
He  made  it  the  subject  of  a  philosophical  dissertation,  in  which  he  con- 
tended that  it  was,  like  masturbation,  a  justifiable  act.  After  repeated  ex- 
periments, which  he  made  on  himself  with  various  poisons,  he  attempted 
suicide  with  fifty-seven  grains  of  opium ;  but  he  was  saved,  and  sent  to  an 
asylum. 

Patient  is  destitute  of  moral  and  social  feelings.  His  writings  dis- 
close incredible  frivolity  and  vulgarity.  His  knowledge  is  of  a  wide 
range,  but  his  logic  is  peculiarly  distorted.  There  is  no  trace  of  emotion- 
ality.    He  treats  everything  (even  the  sublime)  with  incomparable  cyni- 


GENERAL   PATHOLOGY.  45 

cism  and  irony.  He  pleads  for  the  justification  of  suicide  with  false 
philosophical  premises  and  conclusions,  and,  as  one  would  speak  of  the 
mqst  indifferent  affair,  he  declares  that  he  intends  to  accomplish  it.  He 
regrets  that  his  penknife  has  been  taken  from  him.  If  he  had  it  he  would 
open  his  veins  as  Seneca  did, — in  the  bath.  A  short  time  before  a  friend 
had  given  him,  instead  of  a  poison  as  he  supposed,  a  cathartic.  Instead 
of  having  been  a  means  to  send  him  to  the  other  world,  it  had  sent  him 
to  the  water-closet.  Only  the  Great  Operator  could  eradicate  his  foolish 
and  fatal  idea  by  removing  his  senses,  etc. 

The  patient  has  a  large,  rhombic,  distorted  skull,  the  left  half  of  the 
forehead  being  flatter  than  the  right.  The  occiput  is  very  straight.  Ears 
far- back,  widely  projecting,  and  the  external  meatus  forms  a  narrow  slit. 
Genitals  very  lax ;  testicles  unusually  soft  and  small. 

Now  and  then  the  patient  suffers  with  onomatomania.  He  is  com- 
pelled to  think  of  the  most  useless  problems  and  give  up  to  an  inter- 
minable distressing  and  worrying  thought ;  and  is  so  fatigued  after  it 
that  he  is  no  longer  capable  of  any  rational  thought.  After  some  months 
the  patient  was  sent  home  unimproved.  There  he  spent  his  time  in 
reading  and  frivolities,  and  busied  himself  with  the  thought  of  founding 
a  new  Christianity,  because  Christ  had  been  subject  to  grand  delusions 
and  had  deceived  the  world  with  wonders  (!).  After  remaining  at  home 
some  years  the  sudden  occurrence  of  a  maniacal  outbreak  brought  him 
again  to  the  asylum.  He  presented  a  mixture  of  primordial  delirium  of 
persecution  Cdevil,  anti-christ,  persecution,  poisoning,  persecutory  voices) 
and  delusions  of  grandeur  (Christ,  redemption  of  the  world),  with  im- 
pulsive, incoherent  actions.  After  five  months  there  was  a  remission  of 
this  intercurrent  acute  mental  disease,  and  the  patient  returned  to  the 
level  of  his  original  intellectual  peculiarity  and  moral  defect. 

Case  9.  E.,  aged  30,  journeyman-painter,  was  arrested  while  trying 
to  cut  off  the  scrotum  of  a  boy  he  had  caught  in  the  woods.  He  gave  as 
a  motive  for  this  act  that  he  wished  to  cut  into  it  in  order  that  the  world 
should  not  multiply.  Often  in  his  youth,  with  like  purpose,  he  had  cut 
into  his  own  genitals. 

It  is  impossible  to  learn  anything  of  his  ancestry.  From  his  child- 
hood he  was  mentally  abnormal,  violent,  never  lively,  very  irritable, 
irascible,  selfish,  and  weak-minded.  He  hated  women,  loved  solitude,  and 
read  much.  He  sometimes  laughed  to  himself  and  did  silly  things.  Of 
late  years  his  hatred  of  women  had  increased,  especially  of  those  that 
were  pregnant,  they  being  responsible  for  the  misery  of  the  world.  He 
also  hated  children,  and  cursed  his  father.  He  entertained  communistic 
ideas,  and  berated  the  rich  and  the  ministry,  and  God,  who  had  allowed 
him  to  come  into  the  world  so  poor.  He  declared  that  it  would  be  better 
to  castrate  all  children  than  to  allow  others  to  come  into  the  world  that 
could  only  be  fated  to  endure  poverty  and  misery.  He  had  always  had 
the  intention,  from  his  fifteenth  year,  to  castrate  himself,  in  order  to  have 


46  PSYCHOPATHIA   SEXUALIS. 

no  part  in  increasing  unhappiness  and  adding  to  the  number  of  men.  He 
hated  the  female  sex  because  it  was  a  means  of  procreation.  Only  twice 
in  his  life  had  he  allowed  women  to  practice  manustupration  on  him,  and, 
with  the  exception  of  this,  he  had  never  had  anything  to  do  with  them. 
Occasionally  he  had  sexual  desire,  but  never  for  a  natural  satisfaction  of 
it.  When  nature  did  not  help  him,  he  occasionally  helped  himself  by 
means  of  masturbation. 

He  is  a  powerful,  muscular  man.  The  formation  of  the  genitals  pre- 
sents no  abnormality.  On  the  scrotum  and  penis  are  numerous  scars, 
which  resulted  from  his  attempts  at  self-emasculation,  but  which,  he 
asserts,  were  not  carried  out  on  account  of  pain.  Genu  valgum  of  right 
limb.  No  evidence  of  onanism  could  be  discovered.  He  is  moody, 
defiant,  irritable.  Social  feelings  are  absolutely  foreign  to  him.  With 
the  exception  of  imperfect  sleep  and  frequent  headaches,  there  are  no 
functional  disturbances. 

From  cases  of  this  kind,  depending  on  cerebral  causes, 
there  must  be  distinguished  others  where  the  absence  of  func- 
tion arises  from  an  absence  or  malformation  of  the  generative 
organs,  as  in  certain  hermaphrodites,  idiots,  and  cretins.  A 
case  belonging  here  is  found  in  Maschka's  hand-book. 

Case  10.  Complainant  pleads  for  divorce  on  account  of  impotence 
of  her  husband,  who  has  never  had  intercourse  with  her.  She  is  thirty- 
one  years  old,  and  a  virgin.  The  husband  is  somewhat  weak  mentally, 
physically  strong ;  the  genitals  well  developed.  He  declares  that  he  has 
never  had  a  complete  erection  or  a  flow  of  semen,  and  says  that  he  is 
totally  indifferent  about  intercourse  with  women. 

Ultzmann's1  observations  show  that  anaesthesia  sexualis  is 
not  caused  by  aspermia  simply.  He  shows-  that  even  in  con- 
genital aspermia  the  vita  sexualis  and  sexual  power  may  be 
entirely  satisfying ;  an  additional  proof  that  defective  libido  ab 
origine  is  to  be  sought  for.  in  cerebral  conditions. 

The  naturce  frigidas  of  Zacchias  are  examples  of  a  milder 
form  of  anaesthesia.  They  are  met  more  frequently  among 
women  than  among  men.  The  characteristic  signs  of  this 
anomaly  are :  slight  inclination  to  sexual  intercourse,  or  pro- 
nounced disinclination  to  coitus  without  sexual  equivalent,  and 


1  "  Ueber  mannliche  Sterilitat,"  Wiener  med.  Presse,  1878,  Nr.  1.  "  Ueber  Potentia 
generandi  et  coeundi,"  Wiener  Klinik,  1885,  Heft  1,  S.  5.  Translated  under  the  title  of 
Geuito-Urinary  Neuroses,  etc.    The  F.  A.  Davis  Company,  Philadelphia. 


GENERAL   PATHOLOGY.  47 

failure  of  corresponding  psychical,  pleasurable  excitation  during 
coitus,  which  is  indulged  in  simply  from  sense  of  duty.  I  have 
often  had  occasion  to  hear  complaints  from  husbands  about  this. 
In  such  cases  the  wives  have  always  proved  to  be  neuropathic 
ab  origine.     Some  were  at  the  same  time  hysterical. 

2.  Acquired  Anaesthesia. 

Acquired  diminution  of  sexual  instinct,  extending  through 
all  degrees  to  extinction,  may  depend  on  various  causes.  These 
may  be  organic  and  functional,  psychical  and  somatic,  central 
and  peripheral.  The  diminution  of  libido,  as  age  advances,  and 
its  temporary  disappearance  after  the  sexual  act,  are  physio- 
logical. The  variations  with  reference  to  the  duration  of  the 
sexual  instinct  are  dependent  upon  individual  factors.  Educa- 
tion and  manner  of  life  have  a  great  influence  upon  the  intensity 
of  the  vita  sexualis.  Intense  mental  activity  (hard  study),  physi- 
cal exertion,  emotional  depression,  and  sexual  continence  de- 
cidedly diminish  sexual  inclination.  Continence  at  first  induces 
increase,  but  sooner  or  later,  according  to  constitutional  condi- 
tions, the  activity  of  the  generative  organs  decreases,  and  with 
it  libido.  At  all  events,  in  a  person  sexually  mature,  a  close 
connection  exists  between  the  activity  of  the  generative  glands 
and  the  degree  of  libido.  That  this  relation  is  not  determinate 
is  shown  by  the  cases  of  sensual  women,  who,  after  the  climac- 
terium, continue  to  have  sexual  intercourse,  and  may  mani- 
fest states  of  sexual  excitement  (cerebral).  Also  in  eunuchs 
it  is  seen  that  libido  may  long  outlast  the  production  of 
semen. 

On  the  other  hand,  however,  experience  teaches  that  libido 
is  essentially  conditioned  by  the  function  of  the  generative 
glands,  and  that  the  facts  mentioned  are  exceptional  manifesta- 
tions. As  peripheral  causes  of  diminution  or  extinction  of  libido, 
may  be  mentioned  castration,  degeneration  of  the  sexual  glands, 
marasmus,  sexual  excesses  in  the  form  of  coitus  and  masturba- 
tion, and  alcoholism  [cocainism].  In  the  same  way,  the  disap- 
pearance of  libido  in  general  disturbances  of  nutrition  (diabetes, 
morphinism,  etc.)  may  be  explained.     Finally,  the  atrophy  of 


48  PSYCHOPATHIA   SEXUALIS. 

the  testicles  should  be  remembered,  which  has  sometimes  been 
observed  to  follow  focal  lesions  of  the  brain  (cerebellum). 

A  diminution  of  the  vita  sexualis,  from  degeneration  of  the 
tracts  of  the  cord  and  genito-spinal  centre,  occurs  in  diseases  of 
the  spinal  cord  and  brain.  A  central  interference  with  the 
sexual  instinct  may  be  organically  induced  by  cortical  disease 
(dementia  paralytica  in  its  advanced  stages) ;  functionally,  by 
hysteria  (central  anaesthesia'?)  and  emotional  insanity  (melan- 
cholia, hypochondria). 

C.  Hyperesthesia  (Abnormally  Increased  Sexual  Desire). 

Pathology  has  no  easy  task,  in  the  single  case,  when  it  has 
to  decide  whether  the  impulse  to  sexual  satisfaction  has  reached 
a  pathological  degree.  Emminghaus  ("  Psychopathologie,"  p. 
225)  declares  that  the  immediate  re-awakening  of  desire  after 
satisfaction,  with  its  occupation  of  the  entire  attention,  and  no 
less  the  excitation  of  libido  by  the  sight  of  persons  and  things 
which  in  themselves  should  have  but  an  indifferent  sexual 
effect,  are  decidedly  abnormal.  In  general,  sexual  instinct  and 
its  corresponding  needs  are  in  proportion  to  physical  strength 
and  age.  Sexual  desire  rapidly  increases  after  puberty,  until 
it  reaches  a  marked  degree ;  is  strongest  from  the  twentieth  to 
the  fortieth  year,  and  then  slowly  decreases.  Married  life  seems 
to  preserve  and  control  the  instinct.  Sexual  intercourse  with 
many  persons  increases  the  desire. 

Since  woman  has  less  sexual  need  than  man,  a  predominat- 
ing sexual  desire  in  her  arouses  a  suspicion  of  its  pathological 
significance;  and  the  more,  when  this  finds  expression  in  desire 
for  adornment,  coquetiy,  or  male  society,  which,  passing  beyond 
the  limits  set  by  good  breeding  and  manners,  becomes  quite 
noticeable. 

The  constitution,  in  both  sexes,  is  of  the  greatest  signifi- 
cance. An  abnormally  strong  sexual  instinct  is  frequently 
accompanied  by  a  neuropathic  constitution ;  and  such  individuals 
pass  a  great  part  of  their  lives  heavily  burdened  with  the  weight 
of  this  constitutional  anomaly  of  their  sexual  life.  The  power 
of  the  sexual  impulse  in  such  cases  may  at  times  rise  to  the 


GENERAL   PATHOLOGY.  49 

importance  of  an  organic  necessity,  and  really  endanger  the 
freedom  of  the  will.  The  want  of  satisfaction  of  this  impulsive 
desire  may,  under  such  conditions,  induce  a  condition  allied 
to  actual  rutting,  or  a  psychical  condition,  accompanied  by 
emotions  of  fear,  in  which  the  individual  gives  up  to  the 
impulse,  and  responsibility  becomes  doubtful.  If  the  individual 
does  not  give  up  to  his  powerful  impulse,  he  is  in  danger,  by 
reason  of  his  enforced  abstinence,  of  ruining  his  nervous  system 
by  inducing  a  neurasthenia,  or  seriously  increasing  such  a  con- 
dition if  it  be  already  present.  In  normally  constituted  indi- 
viduals, too,  the  sexual  instinct  is  an  inconstant  quantity. 
Aside  from  the  temporary  indifference  following  satisfaction, 
and  the  diminution  of  sexual  desire  in  long-continued  con- 
tinence after  a  certain  reactionary  stage  of  sexual  desire  is 
overcome,  the  manner  of  life  has  a  great  influence.  Those 
living  in  large  cities,  who  are  constantly  reminded  of  sexual 
things  and  incited  to  sexual  enjoyment,  certainly  have  more 
sexual  desire  than  those  living  in  the  country.  A  dissipated, 
luxurious,  sedentary  manner  of  life,  preponderance  of  animal 
food,  and  the  consumption  of  spirits,  spices,  etc.,  have  a  stimu- 
lating influence  on  the  sexual  life.  In  woman  the  sexual 
inclination  is  post-menstrually  increased.  At  this  time,  in 
neuropathic  women,  the  excitement  may  reach  a  pathological 
degree. 

The  great  libido  of  consumptives  is  remarkable.  Hofmann 
tells  of  a  consumptive  peasant  who  satisfied  his  wife  sexually 
on  the  evening  before  his  death. 

The  sexual  acts  are  coitus  (eventually  rape)  and,  fautc 
de  rnieux,  masturbation ;  and,  with  defective  moral  sense, 
pederasty  or  bestiality.  If  sexual  power  is  diminished  or  ex- 
tinct, with  excessive  sexual  desire,  all  manner  of  perversity  of 
sexual  acts  becomes  possible. 

Excessive  libido  may  be  peripherally  or  centrally  induced. 
The  former  manner  of  origin  is  the  more  infrequent.  Pruritus 
and  eczema  of  the  genitals  may  cause  it ;  and  likewise  certain 
substances,  like  cantharides,  which  powerfully  stimulate  sexual 
desire.     Not  infrequently,  in  women  at  the  climacteric,  sexual 


50  PSTCHOPATHIA    SEXUALIS. 

excitement  occurs,  occasioned  by  pruritus;  and  also  in  cases 
where  there  is  neuropathic  taint.  Magnan  (Annates  medico- 
paychol.,  1885,  p.  157)  reports  the  case  of  a  lady  who  was 
afflicted  mornings  with  attacks  of  frightful  erethismus  genitalis, 
and  the  case  of  a  man,  aged  55,  who  was  tormented  at  night 
by  unbearable  priapism.    In  each  case  there  was  a  neurosis. 

The  central  origin  of  sexual  excitement  is  of  frequent 
occurrence1  in  persons  having  neurotic  taint  or  hysteria,  and 
in  conditions  of  psychical  exaltation.  Here,  where  the  cortex 
and  the  psycho-sexual  centre  are  in  a  condition  of  hyperes- 
thesia (abnormal  excitability  of  the  imagination,  increased  ease 
of  association),  not  only  visual  and  tactile  impressions,  but 
also  auditory  and  olfactory  sensations,  may  be  sufficient  to  call 
up  lascivious  concepts. 

Magnan  (op.  cit.)  reports  the  case  of  a  3Toung  woman  who  had  an 
increasing  sexual  desire  from  puberty,  and  satisfied  it  by  masturbation. 
Gradually  she  grew  to  become  sexually  excited  at  the  sight  of  any  man 
pleasing  to  her ;  and,  since  she  was  unable  to  control  herself,  she  would 
sometimes  shut  herself  up  in  a  room  until  the  storm  had  passed.  At  last 
she  gave  herself  up  to  men  of  her  choice,  that  she  might  get  rest  from 
her  tormenting  desire ;  but  neither  coitus  nor  masturbation  brought  relief, 
and  she  went  to  an  asylum. 

The  case  of  a  mother  of  five  children  is  added,  who,  in  despair  about 
her  inordinate  sexual  impulse,  attempted  suicide,  and  then  sought  an 
asylum.  There  her  condition  improved,  but  she  never  trusted  herself  to 
leave  it. 

There  are  several  illustrative  cases  in  men  and  women  in 
the  author's  article,  "  On  Certain  Anomalies  of  Sexual  Instinct," 
Cases  6  and  7  (Archiv  fur  Psychiatrie^  vii,  2) ;  Cases  3  and  5  are 
given  here. 


1  In  individuals  in  whom  intense  sexual  hypersesthesia  is  associated  with  acquired 
irritable  weakness  of  the  sexual  apparatus,  it  is  possible  that  simply  at  the  sight  of  a 
pleasing  female  figure,  without  peripheral  irritation  of  the  genitals,  not  only  the  mechanism 
of  erection,  but  also  that  of  ejaculation,  may  be  excited  to  action  from  the  psycho-sexual 
centre.  For  such  individuals,  all  that  is  necessary  to  induce  orgasm,  or  even  ejaculation,  is 
to  imagine  themselves  in  a  sexual  situation  with  a  female  that  sits  opposite  them  in  railway- 
coupe  or  drawing-room.  Hammond  {op.  cit.,  p.  40)  describes  several  cases  of  this  kind 
that  came  to  him  for  treatment  for  impotence  that  followed ;  and  he  mentions  that  these 
individuals  used  the  term  "  ideal  coitus  "  for  the  act.  Dr.  Moll,  of  Berlin,  told  me  of  a 
similar  case  ;  and  in  this  instance  the  same  designation  was  chosen  for  the  act. 


GENERAL   PATHOLOGY.  51 

Case  11.  On  the  afternoon  of  July  7, 1874,  Clemens,  engineer,  being 
on  his  way,  on  business,  from  Trieste  to  Vienna,  left  the  train  at  the  town 
of  Bruck,  and,  passing  through  the  town  to  the  neighboring  village  of 
St.  Ruprecht,  attempted  a  rape  on  an  old  woman,  aged  70,  whom  he  found 
alone  in  a  house.  He  was  seized  by  the  neighbors  and  arrested  by  the 
local  police.  At  his  hearing  he  declared  that  he  had  tried  to  find  the 
pound,  in  order  to  satisfy  his  sexual  desire  with  a  bitch.  He  said  that  he 
often  suffered  with  such  sexual  excitement.  He  did  not  deny  his  act, 
but  excused  it  as  the  result  of  disease.  The  heat,  the  motion  of  the  cars, 
and  anxiety  about  his  family,  to  which  he  wished  to  go,  had  confused 
him  and  made  him  ill.  Shame  and  remorse  were  not  shown.  His  con- 
duct was  open,  his  mien  gay ;  eyes  red  and  bright,  head  hot,  tongue  coated  ; 
pulse  full,  soft,  beating  over  100;  fingers  somewhat  tremulous.  The  state- 
ments of  the  accused  were  precise,  but  hurried;  his  glance  uncertain,  and 
with  an  unmistakable  expression  of  lasciviousness.  To  the  medical  expert 
summoned  to  examine  him,  he  gave  the  impression  of  one  suffering  with 
disease, — as  if  he  were  in  the  beginning  of  alcoholic  insanity. 

C.  is  forty-five  years  old,  married,  father  of  one  child.  He  does  not 
know  what  diseases  his  parents  or  other  members  of  his  family  have  had. 
In  childhood  he  was  weak  and  neuropathic.  At  the  age  of  five  his  head 
was  injured  by  a  blow  with  a  hoe.  A  scar  one-half  cm.  broad  by  one  cm. 
long,  situated  on  the  right  parietal  and  frontal  bones,  dates  from  that 
injury.  The  bone  is  here  somewhat  depressed.  The  overlying  skin  is 
united  to  the  bone.  Pressure  at  this  point  causes  pain,  which  radiates 
along  the  lower  branch  of  the  trigeminus.  This  spot  is  also  frequently 
spontaneously  painful.  In  his  youth  he  had  frequent  attacks  of  "  faint- 
ing " ;  before  puberty,  pneumonia,  rheumatism,  and  intestinal  catarrh. 
At  the  age  of  seven  he  experienced  a  peculiar  inclination  for  men, — i.e.,  for 
a  certain  superior.  Whenever  he  saw  this  man  he  had  a  peculiar  feeling 
in  his  heart ;  kissed  the  ground  he  walked  on.  At  ten  he  fell  in  love  with 
a  certain  deputy.  Later  he  had  an  enthusiasm  for  men,  though  it  was 
entirely  platonic.  He  began  to  masturbate  at  the  age  of  fourteen ;  first 
intercourse  at  seventeen.  Then  the  earlier  manifestations  of  contrary 
sexual  feeling  disappeared  entirely.  At  that  time  he  passed  through  a 
peculiar  acute  psychopathic  condition,  which  he  described  as  a  kind  of 
clairvoyance.  From  fifteen,  haemorrhoids,  with  symptoms  of  plethora 
abdominalis.  When  he  had  profuse  haemorrhoidal  haemorrhage,  which 
occurred  usually  every  three  or  four  weeks,  he  was  better.  At  other 
times  he  was  constantly  in  a  condition  of  painful  sexual  excitement,  which 
he  satisfied  partly  by  means  of  onanism  and  partly  by  coitus.  Every 
woman  he  met  excited  him  ;  even  when  he  was  among  female  relatives  he 
was  impelled  to  make  indecent  proposals.  Sometimes  it  was  possible  for 
him  to  master  his  desire ;  sometimes  he  was  driven  to  indecent  acts.  If, 
after  these,  he  was  kicked  out-of-doors,  it  seemed  perfectly  right  to  him  ; 
for  he  thought  that  he  needed  such  correction  and  support  against  his 

0,  OF  ILL  Lia 


52  PSYCHOPATHIA   SEXUALIS. 

powerful  impulse,  which  was  a  burden  to  him.     No  periodicity  in  this 
sexual  excitement  was  recognizable. 

Until  1861  he  committed  excesses  in  venery  and  was  several  times 
infected  with  gonorrhoea  and  chancres.  In  1861,  marriage.  He  was 
sexually  satisfied,  but  became  a  burden  to  his  wife  on  account  of  his  great 
sensuality.  In  1864  he  passed  through  an  attack  of  mania  in  the  hospital 
at  Fiume,  and  in  the  same  year  he  again  fell  ill,  and  was  taken  to  the 
insane  asylum  at  Ybbs,  where  he  remained  until  1867.  There  he  suffered 
with  recurrent  mania  accompanied  by  great  sexual  excitement.  He  says 
that  intestinal  catarrh  and  anxiety  were  the  cause  of  his  illness  at  that 
time. 

Thereafter  he  was  well,  but  he  suffered  much  on  account  of  his 
excessive  sexual  desire.  If  he  were  absent  from  his  wife  but  a  short  time, 
the  impulse  became  so  powerful  that  man  or  animal  was  indifferent  to  him 
for  the  satisfaction  of  his  lust.  In  summer  these  impulses  were  much 
stronger,  and  were  always  accompanied  by  abdominal  plethora.  Some- 
thing that  he  remembered  in  medical  reading,  made  him  thiuk  that  in  his 
case  the  ganglionic  system  was  more  powerful  than  the  cerebral.  In 
October,  1873,  on  account  of  business,  he  had  to  leave  his  wife.  From 
that  time  until  Easter,  with  the  exception  of  occasional  masturbation, 
there  was  no  sexual  indulgence.  After  that  he  made  use  of  women  and 
bitches.  From  the  middle  of  June  until  July  7,  he  had  no  opportunity 
for  sexual  indulgence.  He  felt  nervously  excited,  relaxed,  and  as  if  he 
were  going  crazy.  Of  late  he  had  slept  badly.  A  longing  for  his  wife, 
who  lived  in  Vienna,  drove  him  to  leave  his  business.  He  obtained  leave 
of  absence.  The  heat  and  the  noise  of  the  train  confused  him,  and  he 
could  no  longer  hold  out  against  his  sexual  excitement  and  the  pressure 
of  blood  in  his  abdomen.  Everything  danced  before  his  eyes.  He  left 
the  car  at  Bruck,  and  was  absolutely  confused,  not  knowing  where  he 
went ;  and  for  a  moment  the  thought  came  to  him  to  throw  himself  in  the 
water ;  all  was  like  a  mist  before  his  eyes.  Then  he  saw  a  woman,  exposed 
his  genitals,  and  tried  to  embrace  her.  She  cried  for  help,  and  thus  he 
was  arrested. 

•  After  the  attempt  it  suddenly  became  clear  to  him  what  he  had 
done.  He  openly  confessed  his  crime,  which  he  remembered  in  all  its 
details,  but  which  seemed  to  him  to  be  something  abnormal.  He  could 
not  help  it.  For  some  days  after  this,  C.  suffered  with  headache  and 
congestions,  and  was  now  and  then  excited  and  restless,  and  slept  badly. 
His  mental  functions  are  undisturbed,  but  he  is,  nevertheless,  a  con- 
genially peculiar  man,  with  a  character  weak  and  devoid  of  energy.  The 
facial  expression  has  something  lascivious  and  peculiar  about  it.  He 
suffers  with  haemorrhoids.  The  genitals  present  nothing  abnormal. 
The  cranium  is  narrow  and  retreating  at  the  forehead.  Body  large  and 
well  nourished.  With  the  exception  of  diarrhoea,  there  is  no  disturbance 
of  the  vegetative  functions. 


GENERAL   PATHOLOGY.  53 

Case  12.  Mrs.  E.,  aged  47.  Uncle  on  father's  side  was  insane; 
father  was  sanguine,  and  given  to  excess  in  venery.  Patient's  brother 
died  of  an  acute  cerebral  affection.  Patient  from  childhood  has  been  ner- 
vous, eccentric,  and  romantic,  and  while  little  more  than  a  child  mani- 
fested excessive  sexual  desire,  and  at  ten  began  sexual  indulgence.  At 
nineteen,  marriage.  Unhappy  married  life ;  her  husband,  who  was  normal, 
did  not  satisfy  her,  and  until  recent  years  she  constantly  had  other  friends 
besides  her  husband.  She  was  well  aware  of  the  immorality  of  her  life, 
but  felt  her  powerlessness  against  her  insatiable  desire,  which  she  sought 
to  keep,  at  least  outwardly,  a  secret.  Later  she  thought  that  she  had 
suffered  with  a  "  mania  for  men."  Patient  has  borne  six  children.  Six 
years  ago  she  was  thrown  from  a  wagon  and  received  a  severe  cerebral 
concussion.  Following  this  there  was  melancholia,  with  delusions  of 
persecution,  which  sent  her  to  the  asylum.  She  is  approaching  the 
climacterium,  and  of  late  the  menses  have  been  profuse  and  too  frequent. 
Since  this  period  she  is  pleased  to  note  that  the  previously  powerful 
sexual  impulse  has  declined.  Proper  behavior.  Slight  degree  of 
descensus  uteri  and  prolapsus  ani. 

Hyperesthesia  sexualis  may  be  continuously  present  with 
exacerbations,  or  it  may  be  intermittent  or  periodic.  In  the 
latter  case  it  is  a  cerebral  neurosis  per  se  (vide  "  Special 
Pathology"),  or  an  accompanying  symptom  of  a  condition  of 
general  psychical  excitement  (mania ;  episodically  in  dementia 
paralytica,  dementia  senilis,  etc.). 

Lentz   has  published  a   remarkable  case  of  intermittent 

satyriasis  (Bulletin  de  la  societe   de  med.  legale  de  Belgique, 

Nr.  21):— 

Case  13.  For  three  years  the  generally  respected  farmer  D.,  married, 
aged  35,  has  manifested  states  of  sexual  excitement,  with  increasing  fre- 
quency and  severity,  which,  during  the  past  year,  have  become  true 
paroxysms  of  satyriasis.  It  was  impossible  to  discover  hereditary  or 
other  organic  cause.  D.  was  compelled,  at  times  when  his  sexual  ex- 
citement was  excessive,  to  perform  the  sexual  act  from  ten  to  fifteen 
times  in  twenty-four  hours,  without  deriving  any  feeling  of  satisfaction. 
Gradually  he  developed  a  condition  of  general  nervous  hyper-irritability 
{erethisme  general)  with  increased  emotional  irritability  to  the  extent  of 
pathological  outbreaks  of  anger,  and  impulse  to  over-indulgence  in  alco- 
hol, which  induced  symptoms  of  alcoholism.  His  attacks  of  satyriasis 
became  so  violent  that  consciousness  was  interfered  with,  and  the  patient 
raged  about  in  blind  impulse  to  sexual  acts.  He  demanded  that  his  wife 
give  herself  to  other  men  or  to  animals  in  his  presence ;  that  she  allow 
copulation  with  him,  presentibus  Jiliabus,  because  this  would  afford  him 


54  PSYCHOPATHIA   SEXUALIS. 

greater  enjoyment.  Memory  for  the  events  at  the  height  of  these  attacks, 
in  which  the  extreme  irritability  even  led  to  outbreaks  of  maniacal  rage, 
was  entirely  wanting.  D.  himself  thought  that  he  must  have  had  moments 
in  which  he  no  longer  had  control  of  his  senses,  and  without  satisfaction 
from  his  wife  would  have  been  compelled  to  seize  the  next  best  female. 
After  an  attack  of  violent  emotion,  these  attacks  of  sexual  excitement 
suddenly  disappeared  entirely. 

The  two  following  cases  show  how  powerful,  dangerous, 
and  painful  sexual  hypereesthesia  may  become  in  those  afflicted 
with  this  anomaly  : — 

Case  14.  Hyperesthesia  Sexualis — Delirium  Acutum  ex  Abstinentia. 
— On  May  29,  1882,  F.,  aged  29,  single,  shoemaker,  was  received  at  the 
clinic.  Father  was  of  passionate  temper;  mother  neuropathic,  and  had 
an  insane  brother.  Patient  had  never  been  seriously  ill  previously,  and 
was  not  a  drinker,  but  had  always  been  sexually  very  passionate.  Five 
days  before,  he  was  taken  acutely  ill  mentally.  He  made  two  attempts 
at  rape  in  broad  daylight,  before  witnesses,  and  when  arrested  talked 
in  delirium  only  of  obscene  things,  and  masturbated  without  stint,  and 
for  three  days  had  been  raving  mad.  On  admission  he  presented  the 
picture  of  a  severe  acute  delirium,  with  violent  motor  symptoms  of  irri-' 
tation,  and  fever.     Under  treatment  with  ergotin  a  cure  was  effected. 

On  January  5,  1888,  second  admission,  in  a  state  of  violent  mania. 
On  January  4,  he  had  become  morose,  irritable,  whining,  and  sleepless ; 
and  then,  after  vain  assaults  on  women,  had  manifested  symptoms  of 
increasing  angry  excitement. 

On  January  6,  progress  of  the  condition  to  severe  acute  delirium 

(great   disturbance  of  consciousness,  jactation,  grinding  of  the   teeth, 

grimacing,  and  other  motor  symptoms  of  irritation  ;  temperature  as  high 

.as  40.1°  C.)  ;  impulsive  masturbation.    Recovery  was  complete  by  January 

11,  under  energetic  treatment  with  ergotin. 

After  his  recovery  the  patient  gives  an  interesting  account  of  the 
cause  of  his  illness.  Always  very  passionate  sexually ;  first  coitus  at 
the  age  of  sixteen.  Continence  caused  headache,  great  psj-chical  irrita- 
bility, lassitude,  great  loss  of  pleasure  in  work,  and  sleeplessness.  Since 
he  had  few  opportunities  in  the  country  to  satisfy  his  desire,  he  had 
recourse  to  masturbation.  It  was  necessary  for  him  to  masturbate  once 
or  twice  daily.  No  coitus  in  two  months.  Increasing  sexual  exciteni  ait ; 
could  think  of  nothing  save  means  for  the  gratification  of  his  impulse. 
Masturbation  was  not  sufficient  to  banish  the  constantly  increasing 
torment  ex  abstinentia.  During  the  last  four  da3*s  violent  impulse  to 
coitus ;  increasing  sleeplessness  and  irritability.  There  was  only  a  sum- 
mary recollection  of  the   height  of  the   illness.      Patient  recovered  in 


GENERAL   PATHOLOGY.  55 

December.     A  very  respectable  man ;  he  considers  his  inordinate  desire 
decidedly  pathological,  and  is  anxious  about  his  future. 

Case  15.  On  July  11, 1884,  R.,  aged  33,  servant,  was  admitted  suffer- 
ing with  paranoia  persecutoria  and  neurasthenia  sexualis.  Mother  was 
neuropathic ;  father  died  of  spinal  disease.  From  childhood  he  had  an 
intense  sexual  desire,  of  which  he  became  conscious  as  early  as  his  sixth 
year.  From  this  age,  masturbation  ;  from  fifteenth  year,  faute  de  miens, 
pederasty ;  occasionally,  sodomitic  indulgences.  Later,  abusus  coitus  in 
marriage  cum  uxore.  Now  and  then  even  perverse  impulse  to  commit 
cunnilingus  and  to  administer  cantharides  to  his  wife,  because  her  libido 
did  not  equal  his  own.  His  wife  died  after  a  short  period  of  married  life. 
Patient's  circumstances  became  straightened,  and  he  had  no  means  to 
indulge  himself  sexually.  Then  masturbation  again;  employment  of 
lingua  canis  to  induce  ejaculation.  At  times,  priapism  and  conditions 
approaching  satyriasis.  He  was  then  driven  to  masturbate,  in  order  not 
to  become  stuporous.  Beneficial  diminution  of  the  libido  nimia,  with  the 
gradually  predominating  sexual  neurasthenia  and  hypochondria. 

The  following  case,  valuable  for  an  understanding  of 
many  Messalinas,  some  of  whom  are  historically  celebrated,  is  a 
classical  example  of  pure  hyperesthesia  sexualis,  which  I  take 
from  Trelat's  "Folie  lucide":— 

Case  16.  Mrs.  V.  has  suffered  with  a  passion  for  men  since  her 
earliest  youth.  Of  good  family,  well  bred,  of  pleasant  disposition,  ex- 
ceedingly modest,  she  was,  as  a  little  girl,  a  terror  to  her  family,  because 
she  could  scarcely  be  alone  with  a  person  of  the  opposite  sex,  no  matter 
whether  it  was  with  child  or  man  of  any  age,  without  exposing  herself 
immediately  and  demanding  satisfaction  for  her  sexual  passion,  even  going 
so  far  as  to  lay  hold  of  him.  An  attempt  was  made  to  cure  her  by 
marriage.  She  loved  her  husband  passionately,  but  even  with  him  she 
could  not  keep  from  demanding  coitus  of  every  one  with  whom  she  could 
be  alone,  no  matter  whether  it  was  servant,  laborer,  or  school-boy. 

Nothing  could  cure  her  of  this  impulse.  Even  when  she  became  a 
grandmother,  she  was  still  a  Messalina.  One  day  she  locked  a  twelve-year- 
old  boy  in  her  room  and  tried  to  seduce  him.  The  boy  defended  himself 
and  escaped.  She  was  severely  punished  by  his  brother.  All  was  in  vain. 
She  was  put  in  a  cloister.  There  she  was  an  example  of  morality,  and 
gave  not  the  slightest  cause  for  blame.  Immediately  after  her  return  the 
scandal  began  again.  The  family  banished  her,  and  set  aside  money  to 
support  her.  She  earned  by  her  own  hand-work  enough  to  buy  herself 
lovers.  Any  one  seeing  this  neatly  dressed  matron,  of  good  manners  and 
amiable  disposition,  would  never  suspect  how  recklessly  passionate  she 
still  was  at  the  age  of  sixty -five.     On  January  7,  1854,  her  family,  in 


56  PSYCHOPATHIA   SEXUAUS. 

despair  at  new  scandals,  placed  her  in  an  asylum.  She  lived  there  until 
May,  1858,  when  she  died  of  apoplexia  cerebri,  in  her  seventy-third  year. 
Her  conduct  in  the  asylum  was  exemplary.  Left  to  herself,  and  under 
favorable  conditions,  her  sexual  impulses  manifested  themselves  shortly 
before  her  death.  With  the  exception  of  this,  during  an  observation  of 
four  years  by  physicians  of  the  asylum,  she  never  showed  a  sign  of 
mental  abnormality. 

D.  Paresthesia  of  Sexual  Feeling  (Perversion  op  the  Sexual 

Instinct). 

Iii  this  condition  there  is  perverse  emotional  coloring  of 
the  sexual  ideas.  Ideas  physiologically  and  psychologically  ac- 
companied by  feelings  of  disgust,  give  rise  to  pleasurable  sexual 
feelings;  and  the  abnormal  association  finds  expression  in 
passionate,  uncontrollable  emotion.  The  practical  results  are 
perverse  acts  (perversion  of  the  sexual  instinct).  This  is  more 
easily  the  case  if  the  pleasurable  feelings,  increased  to  passionate 
intensity,  inhibit  any  opposing  ideas  with  corresponding  feelings 
of  disgust ;  or  the  influence  of  such  opposing  concepts  may  be 
impossible  on  account  of  the  absence  or  loss  of  all  ideas  of 
morality,  aesthetics,  and  law.  This  loss,  however,  is  only  too 
frequently  found  where  the  spring  of  ethical  ideas  and  feelings 
(a  normal  sexual  instinct)  has  been  poisoned  from  the  begin- 
ning. 

With  opportunity  for  the  natural  satisfaction  of  the  sexual 
instinct,  every  expression  of  it  that  does  not  correspond  with  the 
purpose  of  nature, — i.e.,  propagation, — must  be  regarded  as  per- 
verse. The  perverse  sexual  acts  resulting  from  paraesthesia  are 
of  the  greatest  importance  clinically,  socially,  and  forensically ; 
and,  therefore,  they  must  here  receive  careful  consideration ;  all 
aesthetic  and  polite  disgust  must  be  overcome. 

Perversion  of  the  sexual  instinct,  as  will  be  seen  from  what 
follows,  is  not  to  be  confounded  with  perversity  in  the  sexual 
act ;  since  the  latter  may  be  induced  by  conditions  which  are 
not  psychopathology.  The  concrete  perverse  act,  monstrous  as 
it  may  be,  is  not  decisive.  In  order  to  differentiate  between 
disease  (perversion)  and  vice  (perversity),  one  must  investigate 
the  whole  personality  of  the  individual  and  the  original  impulse 


SADISM.  57 

leading  to  the  perverse  act.     Therein  will  be  found  the  key  of 
diagnosis  (v.  infra). 

Paresthesia  may  occur  in  combination  with  hyperesthesia. 
This  association  seems  to  be  frequent  clinically.  Sexual  acts 
are  then  confidently  to  be  expected.  The  perverse  direction  of 
sexual  activity  may  be  toward  sexual  satisfaction  with  the 
opposite  or  the  same  sex.  Thus  two  great  groups  of  perver- 
sions of  the  sexual  life  may  be  distinguished. 


I.  Sexual  Inclination  toward  Persons  of  the  Opposite  Sex,  with  Perverse 
Activity  of  the  Instinct. 

1.  Association  of  Active  Cruelty  and  Violence  with  Lust — 
Sadism} — That  lust  and  cruelty  frequently  occur  together  is 
a  fact  that  has  long  been  recognized  and  not  infrequently 
observed.  Writers  of  all  kinds  have  called  attention  to  this 
phenomenon.2  The  not  infrequent  cases  where  individuals  of 
very  excitable  sexual  natures  bite  or  scratch  the  companion  in 
intercourse  fall  within  physiological  limits.3  The  older  authors 
have  called  attention  to  the  relation  between  lust  and  cruelty. 

Blumroder  ("  Ueber  Irresein,"  Leipzig,  1836,  p.  51)  saw  a  man  who 
had  several  wounds  bitten  into  the  pectoral  muscle,  which  a  woman,  in 
great  sexual  excitement,  had  given  him  at  the  acme  of  lustful  feeling 
during  coitus.  Blumroder  ("  Ueber  Lust  und  Schmerz,"  Friedreich's 
Magazin  fur  Seelenkunde,  1830,  ii,  5)  calls  especial  attention  to  the  psy- 
chological connection  between  lust  and  murder.  In  relation  to  this,  he 
especially  refers  to  the  Indian  myths  of  Siva  and  Durga  (Death  and 
Lust)  ;  to  human  sacrifice  with  sensual  mysteries ;  and  to  sexual  instinct 
at  puberty  with  a  lustful  impulse  to  suicide,  with  whipping,  pinching,  and 
pricking  of  the  genitals,  in  the  blind  impulse  to  satisfy  sexual  desire. 
Lombroso  ("  Yerzeni  e  Agnoletti,"  Rome,  1874)  also  cites  numerous  exam- 
ples of  the  occurrence  of  a  desire  to  murder  with  greatly  increased  lust. 


1  So  named  from  the  notorious  Marquis  de  Sade,  whose  obscene  novels  treated  of 
lust  and  cruelty.  In  French  literature  the  expression  "  Sadism  "has  been  applied  to  this 
perversion. 

2  U.  A.  Novalis,  in  his  "  Fragments  "  ;  Gorres,  "  Christliche  Mystik,"  Bd.  iii,  p.  460. 

3  Comp.  also  Alfred  deMusset's  famous  verses  to  the  Andalusian  girl : — 
"  Qu'elle  est  superbe  en  6on  d6sordre — quand  ellc  tombe  les  seins  nus — 

Qu'on  la  voit,  b6ante,  se  tordre — dans  un  baiser  de  rage  et  mordre — 
En  hurlant  des  mots  iuconnus  !" 


58  PSYCHOPATHIA   SEXUALIS. 

On  the  other  hand,  when  murderous  lust  has  been  excited, 
lust  itself  often  follows.  Lombroso  {op.  cit.)  alludes  to  the  fact, 
mentioned  by  Mantegazza,  that,  with  fear  of  being  plundered 
by  bandits,  there  was  always  a  dread  of  brutal  lust.1  These 
examples  form  transitions  to  the  pronounced  pathological  cases. 

The  examples  of  the  degenerate  Caesars  (Nero,  Tiberius)  are  also 
instructive.  They  took  delight  in  having  youths  and  maidens  slaughtered 
before  their  eyes.  Not  less  so  is  the  history  of  that  monster,  Marschalls 
Gilles  de  Rays  (Jacob,  "  Curiosites  de  l'histoire  de  France,"  Paris,  1858), 
who  was  executed  in  1440,  on  account  of  mutilation  and  murder,  which  he 
had  practiced  for  eight  years  on  more  than  eight  hundred  children.  As 
the  monster  confessed  it,  it  was  from  reading  Suetonius  and  the  descrip- 
tions of  the  orgies  of  Tiberius,  Caracalla,  etc.,  that  the  idea  was  gained 
of  locking  children  in  his  castles,  torturing  them,  and  then  killing  them. 
This  inhuman  wretch  confessed  that  in  the  commission  of  these  acts  he 
enjoyed  inexpressible  pleasure.  He  had  two  assistants.  The  bodies  of 
the  unfortunate  children  were  burned,  and  only  a  number  of  heads  of 
particularly  beautiful  children  were  preserved — as  memorials. 

In  an  attempt  to  explain  the  association  of  lust  and  cruelty, 
it  is  necessary  to  return  to  a  consideration  of  the  quasi-physio- 
logical cases,  in  which,  at  the  moment  of  most  intense  lust,  very 
excitable  individuals,  who  are  otherwise  normal,  commit  such 
acts  as  biting  and  scratching,  which  are  usually  the  result  of 
anger.  It  must  further  be  remembered  that  love  and  anger  are 
not  only  the  most  intense  emotions,  but  also  the  only  two  forms 
of  active  (sthenic)  emotion.  Both  seek  their  object,  try'  to 
possess  themselves  of  it,  and  naturally  exhaust  themselves  in  a 
physical  effect  on  it ;  both  throw  the  psycho-motor  sphere  into 
the  most  intense  excitement,  and  thus,  by  means  of  this  excita- 
tion, reach  their  normal  expression. 

From  this  stand-point  it  is  clear  how  lust  impels  to  acts 
that  otherwise  are  expressive  of  anger.2     The  one,  like   the 


1  During  the  excitement  of  battle  the  idea  of  lust  forces  its  way  into  consciousness. 
Comp.  the  description  of  a  battle  by  a  soldier,  by  Grillparzer  : — 

"  And  as  the  signal  rang  out,  the  armies  met,  breast  to  breast — lust  of  the  gods  ! — 
here,  there,  the  murderous  steel  slays  enemy,  friend.  Given  and  taken — death  and  life — 
with  wavering  change — wildly  raging  in  frenzy." 

2  Schulz  (Wiener  Med.  Wochenschrift,  No.  49, 1869)  reports  a  remarkable  case  of  a 
man,  aged  28,  who  could  perform  coitus  with  his  wife  only  after  working  himself  into  an 
artificial  fit  of  anger. 


SADISM.  59 

other,  is  a  state  of  exaltation,  an  intense  excitation  of  the  whole 
psycho-motor  sphere.  Thus  there  arises  an  impulse  to  react 
on  the  object  that  induces  the  stimulus,  in  every  possible  way, 
and  with  the  greatest  intensity.  Just  as  maniacal  exaltation 
easily  passes  to  furibund  destructiveness,  exaltation  of  the 
sexual  emotion  often  induces  an  impulse  to  expend  itself  in 
senseless  and  apparently  harmful  acts.  To  a  certain  extent 
these  are  psychical  accompaniments ;  but  it  is  not  simply  an 
unconscious  excitation  of  innervation  of  muscles  (which  also 
sometimes  occurs  as  blind  violence) ;  it  is  a  true  hyperbulia,  a 
desire  to  exert  the  most  intense  effect  on  the  individual  giving 
rise  to  the  stimulus.  The  most  intense  means,  however,  is  the 
infliction  of  pain. 

Through  such  cases  of  infliction  of  pain,  during  the  most 
intense  emotion  of  lust,  we  approach  the  cases  in  which  a 
real  injury,  wound,  or  death,  is  inflicted  on  the  victim.1  In  these 
cases,  the  impulse  to  cruelty,  which  may  accompany  the  emotion 
of  lust,  becomes  unbounded  in  a  psychopathic  individual;  and, 
at  the  same  time,  owing  to  defect  of  moral  feeling,  all  normal 
inhibitory  ideas  are  absent  or  weakened.  Such  monstrous, 
sadistic  acts  have,  however,  in  men,  in  whom  they  are  much 
more  frequent  than  in  women,  another  source  in  physiological 
conditions.  In  the  intercourse  of  the  sexes,  the  active  or  aggres- 
sive role  belongs  to  man ;  woman  remains  passive,  defensive.2 
It  affords  a  man  great  pleasure  to  win  a  woman,  to  conquer 
her;  and  in  the  ars  amandi,  the  modesty  of  a  woman  who 
keeps  herself  on  the  defensive  until  the  moment  of  surrender, 
is  an  element  of  great  psychological  significance  and  im- 
portance. Under  normal  conditions  a  man  meets  obstacles 
which  it  is  his  part  to  overcome,  and  for  which  nature  has 
given  him  an  aggressive  character.  This  aggressive  char- 
acter, however,  under  pathological  conditions,  may  likewise 
be   excessively   developed,    and   express   itself  in    an   impulse 


1  Concerning  analogous  acts  in  rutting  animals,  vide  Lombroso,  "  The  Criminal." 

2  Among  animals  it  is  always  the  male  who  pursues  the  female  with  proffers  of  love. 
Playful  or  actual  flight  of  the  female  is  not  infrequently  observed  ;  and  then  the  relation  is 
like  that  between  the  beast  of  prey  and  the  victim. 


60  PSYCHOPATHIA   SEXUALIS. 

to  subdue  absolutely  the  object  of  desire,  even  to  destroy  or 
kill  it.1-2 

If  both  these  constituent  elements  occur  together, — the 
abnormally  intensified  impulse  to  a  violent  reaction  toward  the 
object  of  the  stimulus,  and  the  abnormally  intensified  desire  to 
conquer  the  woman, — then  the  most  violent  outbreaks  of  sadism 
occur. 

Sadism  is  thus  nothing  else  than  an  excessive  and  mon- 
strous pathological  intensification  of  phenomena, — possible, 
too,  in  normal  conditions  in  rudimental  forms, — which  accom- 
pany the  psychical  vita  sexualis,  particularly  in  males.  It  is, 
of  course,  not  at  all  necessary,  and  not  even  the  rule,  that  the 
sadistic  individual  should  be  conscious  of  his  instinct.  What 
he  feels  is,  as  a  rule,  only  the  impulse  to  cruel  and  violent 
treatment  of  the  opposite  sex,  and  the  coloring  of  the  idea  of 
such  acts  with  lustful  feelings.  Thus  arises  a  powerful  impulse 
to  commit  the  imagined  deeds.  When  the  actual  motive  of 
this  instinct  is  not  comprehended  by  the  individual,  the  sadistic 
acts  have  the  character  of  impulsive  deeds. 

When  the  association  of  lust  and  cruelty  is  present,  not 
only  does  the  lustful  emotion  awaken  the  impulse  to  cruelty, 
but  vice  versd  ;  cruel  ideas  and  acts  cause  sexual  excitement, 
and  in  this  way  are  used  by  perverse  individuals.3 

1  The  conquest  of  woman  takes  place  to-day  in  the  social  form  of  courting,  in  seduc- 
tion and  deception.  From  the  history  of  civilization  and  anthropology  we  know  that  there 
have  been  times,  as  there  are  savages  to-day  that  practice  it,  where  brutal  force,  robbery, 
or  even  blows  that  made  a  woman  powerless,  were  made  use  of  to  obtain  love's  desire.  It 
is  possible  that  tendencies  to  such  outbreaks  of  sadism  are  atavistic. 

2  In  the  Jahrbucher  fur  Psychologie,  ii,  p.  128,  Schafer  (Jena)  refers  to  the  reports 
of  two  cases  by  A.  Payer.  In  the  first  case  states  of  great  sexual  excitement  were  induced 
by  the  sight  of  battles  or  of  paintings  of  them  ;  in  the  second,  by  cruel  torturing  of  small 
animals  (vide  Case  24).  It  is  added  :  "  The  pleasure  of  battle  and  murder  is  so  predomi- 
nantly an  attribute  of  the  male  sex  throughout  the  animal  kingdom,  that  there  can  be  no 
question  about  the  close  relation  existing  between  this  side  of  the  masculine  character 
and  male  sexuality.  I  believe,  too,  that  by  unprejudiced  observation  I  can  show  that, 
in  men  who  are  absolutely  normal  mentally  and  physically,  the  first  indefinite  and  incom- 
prehensible precursors  of  sexual  excitement  may  be  induced  by  reading  exciting  scenes 
of  the  chase  and  war, — i.e.,  they  give  rise  to  unconscious  longings  for  a  kind  of  satisfaction 
in  warlike  games  (wrestling),  in  which,  also,  the  fundamental  sexual  impulse  to  the  most 
perfect  and  intense  contact  with  a  companion  is  expressed,  with  the  more  or  less  clearly 
defined  secondary  thought  of  conquest." 

3  It  sometimes  happens  that  an  accidental  sight  of  blood,  etc.,  is  what  first  excites 
the  preformed  psychical  mechanism  of  the  sadistic  individual,  and  awakens  the  instinct. 


SADISM.  61 

A  differentiation  of  original  and  acquired  cases  of  sadism 
is  scarcely  possible.  Many  individuals,  tainted  ab  origine,  for  a 
long  time  do  everything  to  conquer  the  perverse  instinct.  If 
they  are  potent,  at  first  they  are  able  to  lead  a  normal  vita 
sexualis,  often  with  the  assistance  of  subjective  ideas  of  a  per- 
verse nature.  Later,  after  the  opposing  motives  of  an  ethical 
and  aesthetic  kind  have  been  gradually  overcome,  and  after  the 
constantly  repeated  experience  that  the  natural  act  does  not 
bring  complete  satisfaction,  the  abnormal  instinct  bursts  forth. 
Owing  to  this  late  expression,  in  acts,  of  an  originally  perverse 
disposition,  the  appearances  are  those  of  an  acquired  perversion. 
As  a  rule,  it  may  be  safely  assumed  that  this  psychopathic  state 
exists  ab  origine. 

Sadistic  acts  vary  in  monstrousness  with  variation  in 
the  power  of  the  perverse  instinct  over  the  individual  afflicted, 
and  with  variation  in  the  strength  of  opposing  ideas  that  may  be 
present,  which  almost  always  are  more  or  less  weakened  by 
original  ethical  defect,  hereditary  degeneracy,  or  moral  insanity. 
Thus  there  arises  a  long  series  of  forms  which  begins  with 
capital  crime  and  ends  with  silly  acts  which  afford  the  perverse 
desires  of  the  sadistic  individual  merely  symbolic  satisfaction. 

Sadistic  acts  may  be  further  differentiated  with  reference 
to  their  nature  :  either  as  they  are  indulged  in  after  consum- 
mated coitus  by  which  the  libido  nimia  remains  unsatisfied ; 
or,  with  diminished  virility,  as  they  are  used  to  stimulate  the 
diminished  power ;  or,  finally,  where  virility  is  absolutely  want- 
ing, as  they  become  an  equivalent  for  the  impossible  coitus,  for 
the  induction  of  ejaculation.  In  the  last  two  cases,  notwith- 
standing the  impotence,  there  is  still  intense  libido;  or  there 
was,  at  least,  intense  libido  in  the  individual  at  the  time  when 
the  sadistic  acts  became  habitual.  Sexual  hyperesthesia  is 
always  to  be  regarded  as  the  basis  of  sadistic  inclinations.  The 
impotence  which  occurs  so  frequently  in  the  psychopathic  and 
neuropathic  individuals  here  considered,  as  a  result  of  excesses 
indulged  in  from  early  youth,  is  usually  dependent  upon  spinal 
weakness.  Often,  too,  there  is  a  kind  of  psychical  impotence, 
induced  by  concentration  of  thought  on  the  perverse  act  with 


62  PSYCHOPATHIA   SEXUALIS. 

simultaneous  fading  of  the  idea  of  normal  satisfaction.  No 
matter  what  the  external  form  of  the  act  may  be,  the  mentally 
perverse  predisposition  and  instinct  of  the  individual  are 
essential  to  an  understanding  of  it. 

(a)  Lust- Murder1  (Lust  Potentiated  as  Cruelty,  Murderous 
Lust  Extending  to  Anthropophagy'). — The  most  horrible  ex- 
ample, and  one  which  most  pointedly  shows  the  connection 
between  lust  and  a  desire  to  kill,  is  the  case  of  Andreas  Bichel, 
which  Feuerbach  published  in  his  "  aktenmassige  Darstellung 
merkw urdiger  Verbrechen." 

13.  puellas  stupratas  neeavit  et  dissecuit.  With  reference  to  one  of 
his  victims,  at  his  examination  he  expressed  himself  as  follows :  "  I  opened 
her  breast  and  with  a  knife  cut  through  the  fleshy  parts  of  the  body. 
Then  I  arranged  the  body  as  a  butcher  does  a  beef,  and  hacked  it  with  an 
axe  into  pieces  of  a  size  to  fit  the  hole  which  I  had  prepared  up  in  the 
mountain  for  burying  it.  I  may  say  that  while  opening  the  body  I  was 
so  greedy  that  I  trembled,  and  could  have  cut  out  a  piece  and  eaten  it." 

Lombroso,  too  ("  Geschlechtstrieb  und  Verbrechen  in  ihren  gegen- 
seitigen  Beziehungen."  Groltdammer's  Archiv,  Bd.  xxx),  mentions  cases 
falling  in  the  same  category.  A  certain  Phillipe  indulged  in  choking 
prostitutes,  post-actum,  and  said  :  "  I  am  fond  of  women,  but  it  is  sport 
for  me  to  choke  them  after  having  enjoyed  them." 

A  certain  Grassi  (Lombroso,  op.  cit.,  p.  12)  was  one  night  seized 
with  sexual  desire  for  a  relative.  Irritated  by  her  remonstrance,  he 
stabbed  her  several  times  in  the  abdomen  with  a  knife,  and  also  stabbed 
her  father  and  uncle  who  attempted  to  hold  him  back.  Immediately 
thereafter  he  hastened  to  visit  a  prostitute  in  order  to  cool  his  sexual 
passion  in  her  arms.  But  this  was  not  sufficient.  He  then  murdered  his 
father  and  slaughtered  several  oxen  in  the  stable. 

It  cannot  be  doubted,  from  what  has  gone  before,  that  a 
great  number  of  so-called  lust-murders  depend  upon  a  combi- 
nation of  hyperesthesia  and  paresthesia  sexualis.  As  a  result 
of  this  perverse  coloring  of  the  feelings,  further  acts  of 
bestiality  with  the  body  may  result,— e.g.,  cutting  it  up  and 
wallowing  in  the  intestines.  The  case  of  Bichel  points  to  this 
possibility. 

A    modern    example    is    that    of    Menesclou    (Annales 

1Comp.  Metzger's  ger.  ArznelwV,  herausgegeben  von  Remer,  p.  539;  Klein's  An- 
nalen,  x,  p.  176,  xviii,  p.  311;  Heinroth,  System  der  psych,  ger.  Med.,  p.  270;  Neuer 
Pitaval,  1855,  23,  Tb.  (Fall  Blaize  Pen-age). 


SADISM.  63 

dliygiene  publique),  who  was  examined  by  Lasegue,  Brouardel, 
and  Motet,  declared  to  be  mentally  sound,  and  executed. 

Case  17.  A  four-year-old  girl  was  missing  from  her  parents'  home, 
April  15,  1880.  On  April  16th,  Menesclou,  one  of  the  occupants  of  the 
house,  was  arrested.  The  forearm  of  the  child  was  found  in  his  pocket, 
and  the  head  and  entrails,  in  a  half-burned  condition,  were  taken  from  the 
stove.  Parts  of  the  body  were  found  in  the  water-closet.  The  genitals 
could  not  be  found.  M.,  when  asked  their  whereabouts,  became  embar- 
rassed. The  circumstances,  as  well  as  an  obscene  poem  found  on  his 
person,  left  no  doubt  that  he  had  violated  the  child  and  then  murdered 
her.  M.  expressed  no  remorse,  asserting  that  his  deed  was  an  accident. 
His  intelligence  is  limited.  He  presents  no  anatomical  signs  of  degen- 
eration ;  is  somewhat  deaf,  and  scrofulous. 

M.,  aged  20  ;  convulsions  at  the  age  of  nine  months.  Later,  he  suf- 
fered from  poor  sleep  (enuresis  nocturna)  ;  was  nervous,  and  developed 
tardily  and  imperfectly.  From  the  time  of  puberty  he  was  irritable, 
showed  evil  inclinations ;  was  lazy  ;  could  not  be  taught,  and  in  all  trades 
proved  to  be  of  no  use.  He  grew  no  better  even  in  the  House  of  Cor- 
rection. He  was  made  a  marine,  but  there,  too,  he  proved  useless.  When 
he  returned  home  he  stole  from  his  parents,  and  spent  his  time  in  bad 
company.  He  did  not  run  after  women,  but  gave  himself  up  passionately 
to  masturbation,  and  occasionally  indulged  in  sodomy  with  bitches.  His 
mother  suffered  with  mania  menstrualis  periodica.  An  uncle  was  insane, 
and  another  an  inebriate.  The  examination  of  M.'s  brain  showed  morbid 
changes  of  the  frontal  lobes,  of  the  first  and  second  temporal  convolutions, 
and  of  a  part  of  the  occipital  convolutions. 

Case  18.  Alton,  a  clerk  in  England,  goes  out  of  town  for  a  walk. 
He  lures  a  child  into  a  thicket,  and  returns  after  a  time  to  his  office,  where 
he  makes  this  entry  in  his  note-book :  "  Killed  to-day  a  young  girl ;  it  was 
fine  and  hot."  The  child  was  missed,  searched  for,  and  found  cut  into 
pieces.  Many  parts,  and  among  them  the  genitals,  could  not  be  found. 
A.  did  not  show  the  slightest  trace  of  emotion,  and  gave  no  explanation 
of  the  motive  or  circumstances  of  his  horrible  deed.  He  was  a  psycho- 
pathic individual,  and  occasionally  subject  to  states  of  depression  with 
t«dium  vitae.  His  father  had  had  one  attack  of  acute  mania.  A  near 
relative  suffered  from  mania  with  homicidal  impulses.     A.  was  executed. 

In  such  cases  it  may  even  happen  that  appetite  for  the  flesh 
of  the  murdered  victim  arises,  and,  in  consequence  of  this  per- 
verse coloring  of  the  idea,  parts  of  the  body  may  be  eaten. 

Case  19.  Leger,  vine-dresser,  aged  24.  From  youth  moody,  silent, 
shy  of  people.  He  starts  out  in  search  of  a  situation.  He  wanders  about 
eight  days  in  the  forest,  there  catches  a  girl  twelve  years  old,  violates  her, 


64  PSYCHOPATHIA   SEXUALIS. 

mutilates  her  genitals,  tears  out  her  heart,  eats  of  it,  drinks  the  blood, 
and  buries  the  remains.  Arrested,  at  first  he  lied,  but  finally  confessed 
his  crime  with  cynical  cold-bloodedness.  He  listened  to  his  sentence  of 
death  with  indifference,  and  was  executed.  At  the  post-mortem  exami- 
nation, Esquirol  found  morbid  adhesions  between  the  cerebral  membranes 
and  the  brain  (Gorget,  "  Darstellung  der  Prozesse  Leger,  Feldtmann," 
etc.,  Darmstadt,  1827). 

Case  20.  Tirsch,  hospital  beneficiary  of  Prag,  aged  55,  always  silent, 
peculiar,  coarse,  very  irritable,  grumbling,  revengeful,  was  sentenced  to 
twenty  years'  imprisonment,  on  account  of  violating  a  girl  ten  j-ears  old. 
He  had  attracted  attention  on  account  of  outbursts  of  anger  from  insig- 
nificant causes,  and  also  on  account  of  tsedium  vita?.  In  1864,  on  account 
of  the  refusal  of  an  offer  of  marriage  which  he  made  to  a  widow,  he  devel- 
oped a  hatred  toward  women,  and  on  July  8th  he  went  about  with  the 
intention  of  killing  one  of  this  hated  sex.  Vetulam  occurentem  in  silvam 
allexit,  coitum  poposcit,  renitentem  prostravit,  jugulum  femime  compressit 
"  furore  captus."  Cadaver  virga  betulse  desecta  verberare  voluit  neque 
tamen  id  perfecit,  quia  conscientia  sua  hsec  fieri  vetuit,  cultello  mammae 
et  genitalia  desecta  domi  cocta  proximis  diebus  cum  globis  comedit.  On 
September  12th,  when  he  was  arrested,  the  remains  of  this  meal  were  found. 
He  gave  as  the  motive  of  this  act  "  inner  impulse."  He  himself  wished  to 
be  executed  because  he  had  always  been  persecuted.  In  confinement 
there  were  great  emotional  irritability  and  occasional  outbursts  of  fury, 
preceded  by  refusal  of  food,  which  made  isolation,  lasting  several  days, 
necessary.  It  was  authoritatively  established  that  the  most  of  his  earlier 
excesses  were  coincident  with  outbreaks  of  excitement  and  fury  (Maschka, 
Prager  Vierteljahrsschrift,  1866,  i,  p.  79). 

The  Whitechapel  murderer,  who  still  eludes  the  vigilance 
of  the  police,  probably  belongs  in  this  category  of  psycho-sexual 
monsters.1  The  constant  absence  of  uterus,  ovaries,  and  labia, 
in  the  victims  (ten)  of  this  modern  Bluebeard,  allows  the  pre- 
sumption that  he  seeks  and  finds  still  further  satisfaction  in 
anthropophagy. 

In  other  cases  of  lust-murder,  for  physical  and  mental 
reasons  (vide  supra),  violation  is  omitted,  and  the  sadistic  crime 
alone  becomes  the  equivalent  of  coitus.  The  prototype  of  such 
cases  is  the  following  one  of  Verzeni.  The  life  of  his  victim 
hung  on  the  rapid  or  retarded  occurrence  of  ejaculation.    Since 

1  Comp.  Spitzka,  The  Journal  of  Nervous  and  Mental  Disease,  December,  1888 ; 
Kiernan,  The  Medical  Standard,  November,  December,  1888. 


SADISM.  65 

this  remarkable  case  presents  all  the  peculiarities  which  modern 
science  knows  concerning  the  relation  of  lust  to  lust-murder 
with  anthropophagy,  and  especially  since  it  was  carefully  studied, 
it  receives  detailed  description  here : — 

Case  21.  Vincenz  Verzeni,  born  in  1849;  since  January  11,  1872, 
in  prison;  is  accused  (1)  of  an  attempt  to  strangle  his  nurse  Marianne, 
four  years  ago,  while  she  lay  sick  in  bed;  (2)  of  a  similar  attempt  on 
a  married  woman,  Arsuffi,  aged  27  ;  (3)  of  an  attempt  to  strangle  a 
married  woman,  Gala,  by  grasping  her  throat  while  kneeling  on  her  body ; 
(4)  on  suspicion  of  the  following  murders : — 

In  December  a  fourteen-year-old  girl,  Johanna  Motta,  set  out  for  a 
neighboring  village  between  seven  and  eight  o'clock  in  the  morning. 
Since  she  did  not  return,  her  master  set  out  to  find  her,  and  discovered 
her  body  near  the  village,  lying  by  a  path  in  the  fields.  The  corpse  was 
frightfully  mutilated  with  numerous  wounds.  The  intestines  and  genitals 
had  been  torn  from  the  opened  body,  and  were  found  near  by.  The  naked- 
ness of  the  body  and  erosions  on  the  thighs  made  it  seem  probable  that 
there  had  been  an  attempt  at  rape ;  the  mouth  filled  with  earth  pointed  to 
suffocation.  In  the  neighborhood  of  the  body,  under  a  pile  of  straw, 
were  found  a  portion  of  flesh  torn  from  the  right  calf,  and  pieces  of 
clothing.     The  perpetrator  of  the  deed  remained  undiscovered. 

On  August  28,  1871,  a  married  woman,  Frigeni,  aged  28,  set  out  in 
the  fields  early  in  the  morning.  Since  she  did  not  return  by  eight  o'clock, 
her  husband  started  out  to  fetch  her.  He  found  her  a  corpse,  lying  naked 
in  the  field,  with  the  mark  of  a  thong  around  her  neck,  with  which  she 
had  been  strangled,  and  with  numerous  wounds.  The  abdomen  had  been 
slit  open,  and  the  intestines  were  hanging  out. 

On  August  29,  at  noon,  as  Maria  Previtali,  aged  19,  went  through  a 
field,  she  was  followed  by  her  cousin,  Verzeni.  He  dragged  her  into  a 
field  of  grain,  threw  her  to  the  ground,  and  began  to  choke  her.  As  he  let 
go  of  her  for  a  moment  to  ascertain  whether  there  were  any  one  near,  the 
girl  got  up  and,  by  her  supplicating  entreaty,  induced  Verzeni  to  let  her 
go,  after  he  had  pressed  her  hands  together  for  some  time. 

Verzeni  was  brought  before  a  court.  He  is  twenty-two  years  old. 
His  cranium  is  of  more  than  average  size,  but  asymmetrical.  The  right 
frontal  bone  is  narrower  and  lower  than  the  left,  the  right  frontal  promi- 
nence being  less  developed,  and  the  right  ear  smaller  than  the  left  (by 
1  centimetre  in  length  and  3  centimetres  in  breadth) ;  both  ears  are 
defective  in  the  inferior  half  of  the  helix  ;  the  right  temporal  artery  is 
somewhat  atheromatous.  Bull-necked ;  enormous  development  of  the 
zygomse  and  inferior  maxilla ;  penis  greatly  developed,  frsenum  wanting ; 
slight  divergent  alternating  strabismus  (insufficiency  of  the  internal  rectus 
muscle,  and  myopia).    Lombroso  concludes,  from  these  signs  of  degenera- 


66  PSYCHOPATHIA   SEXUALIS. 

tion,  that  there  is  a  congenital  arrest  of  development  of  the  right  frontal 
lobe.  As  seemed  probable,  Verzeni  has  a  bad  ancestry, — two  uncles  are 
cretins ;  a  third,  microcephalic,  beardless,  one  testicle  wanting,  the  other 
atrophic.  The  father  shows  traces  of  pellagrous  degeneration,  and  had  an 
attack  of  hypochondria  pellagrosa.  A  cousin  suffered  from  cerebral 
hyperaemia ;  another  is  a  confirmed  thief. 

Verzeni's  family  is  bigoted  and  low-minded.  He  himself  has  ordi- 
nary intelligence ;  knows  how  to  defend  himself  well ;  seeks  to  prove  an 
alibi  and  cast  suspicion  on  others.  There  is  nothing  in  his  past  that 
points  to  mental  disease,  but  his  character  is  peculiar.  He  is  silent  and 
inclined  to  be  solitary.  In  prison  he  is  cynical.  He  masturbates,  and 
makes  every  effort  to  gain  sight  of  women. 

Yerzeni  finally  confessed  his  deeds  and  their  motive.  The  com- 
mission of  them  gave  him  an  indescribably  pleasant  (lustful)  feeling, 
which  was  accompanied  by  erection  and  ejaculation.  As  soon  as  he  had 
grasped  his  victim  by  the  neck,  sexual  sensations  were  experienced.  It 
was  entirely  the  same  to  him,  with  reference  to  these  sensations,  whether 
the  women  were  old,  young,  ugly,  or  beautiful.  Usually,  simply  choking 
them  had  satisfied  him,  and  he  then  had  allowed  his  victims  to  live ;  in 
the  two  cases  mentioned,  the  sexual  satisfaction  was  delayed,  and  he  had 
continued  to  choke  them  until  they  died.  His  satisfaction  in  this  garrot- 
ing  was  greater  than  in  masturbation.  The  abrasions  of  the  skin  on 
Motta's  thighs  were  produced  by  his  teeth,  while  sucking  her  blood  in 
most  intense  lustful  pleasure.  He  had  torn  out  a  piece  of  flesh  from  her 
calf  and  taken  it  with  him  to  roast  at  home ;  but  on  the  way  he  hid  it 
under  the  straw-stack,  for  fear  his  mother  would  suspect  him.  He  also 
carried  pieces  of  the  clothing  and  intestines  some  distance,  because  it 
gave  him  great  pleasure  to  smell  and  touch  them.  The  strength  which 
he  possessed  in  these  moments  of  intense  lustful  pleasure,  was  enormous. 
He  had  never  been  a  fool ;  while  committing  his  deeds  he  saw  nothing 
around  him  (apparently  as  a  result  of  intense  sexual  excitement,  annihila- 
tion of  apperception — instinctive  action).  After  such  acts  he  was  always 
very  happy,  enjoying  a  feeling  of  great  satisfaction.  He  had  never  had 
pangs  of  conscience.  It  had  never  occurred  to  him  to  touch  the  genitals 
of  the  martyred  women,  or  to  violate  his  victims.  It  had  satisfied  him 
to  throttle  them  and  suck  their  blood.  These  statements  of  this  modern 
vampire  seem  to  rest  on  truth.  Normal  sexual  impulses  seem  to  have 
remained  foreign  to  him.  Two  sweethearts  that  he  had,  he  was  satisfied 
to  look  at ;  it  was  very  strange  to  him  that  he  had  no  inclinations  to 
strangle  them  or  press  their  hands ;  but  he  had  not  had  the  same  pleasure 
with  them  as  with  his  victims.  There  was  no  trace  of  moral  sense, — 
remorse  and  the  like. 

Yerzeni  said  himself  that  it  would  be  a  good  thing  if  he  were  to  be 
kept  in  prison,  because  with  freedom  he  could  not  resist  his  impulses. 
Yerzeni  was  sentenced  to  imprisonment  for  life  (Lombroso,"  Yerzeni  e 


SADISM.  67 

Agnoletti,"  Rome,  1873).  The  confessions  which  Verzeni  made  after  his 
sentence,  are  interesting : — 

"  I  had  an  unspeakable  delight  in  strangling  women,  experiencing 
during  the  act  erections  and  real  sexual  pleasure.  It  was  even  a  pleasure 
only  to  smell  female  clothing.  The  feeling  of  pleasure  while  strangling 
them  was  much  greater  than  that  which  I  experienced  while  mastur- 
bating. I  took  great  delight  in  drinking  Motta's  blood.  It  also  gave  me 
the  greatest  pleasure  to  pull  the  hair-pins  out  of  the  hair  of  my  victims. 

"  I  took  the  clothing  and  intestines,  because  of  the  pleasure  it  gave 
me  to  smell  and  touch  them.  At  last  my  mother  came  to  suspect  me, 
because  she  noticed  spots  of  semen  on  my  shirt  after  each  murder  or 
attempt  at  one.  I  am  not  crazy,  but  in  the  moment  of  strangling  my 
victims  I  saw  nothing  else.  After  the  commission  of  the  deeds  I  was 
satisfied  and  felt  well.  It  never  occurred  to  me  to  touch  or  look  at  the 
genitals  or  such  things.  It  satisfied  me  to  seize  the  women  by  the  neck 
and  suck  their  blood.  To  this  very  day  I  am  ignorant  of  how  a  woman 
is  formed.  During  the  strangling  and  after  it,  I  pressed  myself  on  the 
entire  body  without  thinking  of  one  part  more  than  another." 

Verzeni  arrived  at  his  perverse  acts  entirely  independently,  after 
having  noticed,  when  he  was  twelve  years  old,  that  he  experienced  a 
peculiar  feeling  of  pleasure  while  wringing  the  necks  of  chickens.  After 
this  he  had  often  killed  great  numbers  of  them,  and  then  said  that  a 
weasel  had  been  in  the  hen-coop  (Lombroso,  Goltdammer's  Archiv,  Bd. 
xxx,  p.  13). 

Lombroso  mentions  an  analogous  case  (Goldtdammer's 
Archiv)  which  occurred  in  Vittoria  (Spain) : — 

Case  22.  A  certain  Gruyo,  aged  41,  with  a  blameless  past  life, 
having  been  three  times  married,  strangled  six  women  in  the  course  of 
ten  years.  They  were  almost  all  public  prostitutes  and  quite  old.  After 
the  strangling  he  tore  out  their  intestines  and  kidneys  per  vaginam. 
Some  of  his  victims  he  violated  before  killing,  others,  on  account  of  the 
occurrence  of  impotence,  he  did  not.  He  set  about  his  horrible  deeds 
with  such  care  that  he  remained  undetected  for  ten  years. 

(b)  Mutilation  of  Corpses. — Following  the  preceding  hor- 
rible group  of  perversions  of  the  sexual  instinct,  which  arise 
from  hyperesthesia  and  paresthesia  sexualis  with  retained 
virility,  come  naturally  the  necrophiles ;  for  in  these  cases, 
just  as  with  lustful  murderers  and  analogous  cases,  an  idea 
which  in  itself  awakens  a  feeling  of  horror,  and  before  which  a 
healthy  person  would  shudder,  is  accompanied  by  lustful  feel- 


68  PSYCUOPATHIA   SEXUALIS. 

ings,  and  thus   leads    to   the  impulse    to  indulge   in  acts  of 
necrophilia. 

The  cases  of  mutilation  of  bodies  mentioned  in  literature 
seem  to  be  pathological ;  but,  with  the  exception  of  the  cele- 
brated one  of  Sergeant  Bertrand  (v.  infra),  they  come  far  from 
being-  described  and  observed  with  exactness.  In  certain  cases 
there  may  be  nothing  more  than  the  possibility  that  unbridled 
desire  sees  in  the  idea  of  death  no  obstacle  to  its  satisfaction. 
The  seventh  case  mentioned  by  Moreau  is  perhaps  such  a  one : — 

A  man,  aged  23,  attempted  to  rape  a  woman,  aged  53.  Struggling, 
he  killed  her  and  then  violated  her,  threw  her  in  the  water,  and  fished  her 
out  again  for  renewed  violation.  The  murderer  was  executed.  The 
meninges  of  the  anterior  lobes  were  thickened  and  adherent  to  the  cortex. 

French  writers  have  recorded  numerous  examples  of  necrophilia. 
Two  cases  concerned  monks,  where  they  were  performing  the  watch  for 
the  dead.  In  a  third  case  the  subject  was  an  idiot,  who  also  suffered  from 
periodical  mania,  and  after  commission  of  rape  was  sent  to  an  insane 
asylum,  and  there  mutilated  female  bodies  in  the  mortuary. 

In  other  cases,  however,  there  is  undoubtedly  direct  prefer- 
ence of  a  corpse  to  the  living  woman.  When  no  other  act  of 
cruelty — cutting  into  pieces,  etc. — is  practiced  on  the  cadaver, 
it  is  probable  that  the  lifeless  condition  itself  forms  the  stimulus 
for  the  perverse  individual.  It  is  possible  that  the  corpse — a 
human  form  absolutely  without  will — satisfies  an  abnormal 
desire,  in  that  the  object  of  desire  is  seen  to  be  capable  of 
absolute  subjugation,  without  possibility  of  resistance. 

Brierre  de  Boismont  (Gazette  medicate,  July  21,  1859)  relates  the 
history  of  a  corpse-violator  who,  after  bribing  the  watchman,  had  gained 
entrance  to  the  corpse  of  a  girl  of  sixteen,  who  belonged  to  a  family  of 
high  social  position.  At  night  a  noise  was  heard  in  the  death-chamber, 
as  if  a  piece  of  furniture  had  fallen  over.  The  mother  of  the  dead  girl 
effected  an  entrance,  and  saw  a  man  dressed  inJiis  night-shirt  springing 
from  the  bed  where  the  body  lay.  It  was  at  first  thought  that  the  man 
was  a  thief,  but  the  real  explanation  was  soon  discovered.  It  was  after- 
ward ascertained  that  the  culprit,  a  man  of  good  family,  had  often  violated 
the  bodies  of  young  women.     He  was  sentenced  to  imprisonment  for  life. 

The  story  of  a  prelate,  reported  by  Taxil  ("  La  prostitution 
contemporaine,"  p.  171),  is  of  great  interest  as  an  example  of 


SADISM.  69 

necrophilia.  From  time  to  time  he  would  visit  houses  of  prosti- 
tution in  Paris  and  order  a  prostitute,  dressed  in  white  like  a 
corpse,  to  be  laid  out  on  a  bed.  At  the  appointed  hour  he  would 
appear  in  the  room,  which,  in  the  meantime,  had  been  elaborately 
prepared  as  a  room  of  mourning ;  then  he  would  act  as  if  read- 
ing a  mass  for  the  soul,  and  finally  throw  himself  on  the  girl, 
who,  during  the  whole  time,  was  compelled  to  play  the  role  of  a 
corpse.1 

The  cases  in  which  the  perpetrator  injures  and  cnts  up  the 
corpse  are  clearer.  Such  cases  come  next  to  those  of  lust- 
murder,  in  that,  in  these  individuals,  cruelty,  or  at  least  an 
impulse  to  attack  the  female  body,  is  connected  with  lust.  It  is 
possible  that  a  remnant  of  moral  sense  deters  from  the  cruel  act 
on  a  living  woman,  and  possibly  the  fancy  passes  beyond  lust- 
murder  and  rests  on  its  result,  the  corpse.  Here,  also,  it  is 
possible  that  the  idea  of  defenselessness  of  the  body  plays  a 
role. 

Case  23.  Sergeant  Bertrand,  a  man  of  delicate  physical  constitution 
and  of  peculiar  character ;  from  childhood  silent  and  inclined  to  solitude. 

The  details  of  the  health  of  his  family  are  not  satisfactorily  known ; 
but  the  occurrence  of  mental  diseases  in  his  ancestry  is  ascertained.  It  is 
said  that  while  he  was  a  child  he  was  affected  with  destructive  impulses, 
which  he  himself  coidd  not  explain.  He  would  break  whatever  was  at 
hand.  In  early  childhood,  without  teaching,  he  learned  to  masturbate. 
At  nine  he  began  to  feel  inclinations  toward  persons  of  the  opposite  sex. 
At  thirteen  the  impulse  to  sexual  intercourse  became  powerfully  awakened 
in  him.  He  now  masturbated  excessively.  When  he  did  this  his  fancy 
always  created  a  room  filled  with  women.  He  would  imagine  that  he 
carried  out  the  sexual  act  with  them,  and  then  killed  them.  Immediately 
thereafter  he  would  think  of  them  as  corpses,  and  of  how  he  defiled  them. 
Occasionally,  in  such  situations,  the  thought  of  carrying  out  a  similar  act 
with  male  corpses  would  come  up,  but  it  was  always  attended  with  a 
feeling  of  disgust. 

In  time  he  felt  the  impulse  to  carry  out  such  acts  with  actual  corpses. 
For  want  of  human  bodies,  he  obtained  those  of  animals.  He  would  cut 
open  the  abdomen,  tear  out  the  entrails,  and  masturbate  during  the  act. 
He  declares  that  in  this  way  he  experienced  inexpressible  pleasure.     In 


1  Simon  (Crimes  et  D61its,  p.  209)  mentions  an  experience  of  Lacassagne's,  to  whom 
a  respectable  man  said  that  he  was  never  intensely  excited  sexually  except  when  a  spectator 
at  a  funeral. 


70  PSYCHOPATHIA   SEXUALlS. 

1846  these  bodies  no  longer  satisfied  him.  He  now  killed  dogs,  and  pro- 
ceeded with  them  as  before.  Toward  the  end  of  1846  he  first  felt  the 
desire  to  make  use  of  human  bodies.  At  first  he  had  a  horror  of  it.  In 
1847,  being  by  accident  in  a  grave-yard,  he  ran  across  the  grave  of  a  newly- 
buried  corpse.  Then  this  impulse,  with  headache  and  palpitation  of  the 
heart,  became  so  powerful  that,  although  there  were  people  near  by,  and 
he  was  in  danger  of  detection,  he  dug  up  the  body.  In  the  absence  of  a 
convenient  instrument  for  cutting  it  up,  he  satisfied  himself  by  hacking  it 
with  a  shovel. 

In  1847  and  1848,  during  two  weeks,  as  reported,  the  impulse,  accom- 
panied by  violent  headache,  to  commit  brutalities  on  corpses,  actuated 
him.  Amidst  the  greatest  dangers  and  difficulties,  he  satisfied  this  im- 
pulse some  fifteen  times.  He  dug  up  the  bodies  with  his  hands,  in  nowise 
sensible,  in  his  excitement,  to  the  injuries  he  thus  inflicted  on  himself. 
When  he  had  obtained  the  body,  he  cut  it  up  with  a  sword  or  pocket-knife, 
tore  out  the  entrails,  and  then  masturbated.  The  sex  of  the  bodies  is  said 
to  have  been  a  matter  of  indifference  to  him,  though  it  was  ascertained  that 
this  modern  vampire  had  dug  up  more  female  than  male  corpses.  During 
these  acts  he  declares  himself  to  have  been  in' an  indescribable  state  of 
sexual  excitement.  After  having  cut  them  up,  he  had  sometimes  re- 
interred  the  bodies. 

In  July,  1848,  he  accidentally  came  across  the  body  of  a  girl  of 
sixteen.  Then,  for  the  first  time,  he  experienced  a  desire  to  carry  out 
coitus  on  a  cadaver.  "  I  covered  it  with  kisses  and  pressed  it  wildly  to 
my  heart.  All  that  one  could  enjoy  with  a  living  woman  is  nothing  in 
comparison  with  the  pleasure  I  experienced.  After  I  had  enjoyed  it  for 
about  a  quarter  of  an  hour,  I  cut  the  body  up,  as  usual,  and  tore  out  the 
entrails.  Then  I  buried  the  cadaver  again."  Only  after  this,  as  B.  de- 
clares, had  he  felt  the  impulse  to  use  the  bodies  sexually  before  cutting 
them  up,  and  thereafter  he  had  done  it  in  three  instances.  The  actual 
motive  of  the  exhuming  of  the  bodies,  however,  was  then,  as  before,  to 
cut  them  up ;  and  the  enjoyment  in  so  doing  was  greater  than  in  using 
the  bodies  sexually.  The  latter  act  had  always  been  nothing  more  than 
an  episode  of  the  principal  one,  and  had  never  quieted  his  desires ;  there- 
fore, he  had  always  cut  up  the  body  afterward  or  mutilated  another  body. 
The  medico-legal  examiners  gave  an  opinion  of  "  monomania."  Court- 
martial  sentence  to  one  year's  imprisonment.  (Michea,  Union  m&d.,  1 849  ; 
Lunier,  Annal.  med.-psychol.,  1849,  p.  153;  Tardieu,  "Attentats  aux 
moeurs,"  1878,  p.  114  ;    Legrand,  "  La  folie  devant  les  tribun.,"  p.  524.) 

(c)  Injury  of  Women  (Stabbing,  Flagellation,  etc.). — Fol- 
lowing lust-murder  and  violation  of*  corpses,  come  cases  closely 
allied  to  the  former,  in  which  injury  of  the  victim  of  lust  and 
sight  of  the  victim's  blood  are  a  delight  and  pleasure  for  degener- 


SADISM.  ?1 

ate  men.  The  notorious  Marquis  de  Sade,1  after  whom  the  com- 
bination of  lust  and  cruelty  has  been  named,  was  such  a  monster. 
Coitus  only  excited  him  when  he  could  prick  the  object  of  his 
desire  until  the  blood  came.  His  greatest  pleasure  was  to  in- 
jure prostitutes  and  then  bind  their  wounds. 

Here  also  belongs  the  case  of  a  captain  mentioned  by 
Brierre  de  Boismont,  who  always  compelled  the  object  of  his 
affection  to  place  leeches  ad  pudenda  before  coitus,  which  was 
very  frequent.  Finally  this  woman  became  very  anaemic  and, 
as  a  result  of  this,  insane. 

The  following  case,  borrowed  from  my  own  clientele,  very 
clearly  shows  the  connection  between  lust  and  cruelty,  with 
desire  to  shed  and  see  blood : — 

Case  24.  Mr.  X.,  aged  25 ;  father  syphilitic,  died  of  paretic  de- 
mentia ;  mother  hysterical  and  neurasthenic.  He  is  a  weak  individual, 
constitutionally  neuropathic,  and  presents  several  anatomical  signs  of 
degeneration.  When  a  child,  hypochondria  and  imperative  conceptions  ; 
later,  constant  alternation  of  exaltation  and  depression.  While  yet  a 
child  of  ten,  the  patient  felt  a  peculiar  lustful  desire  to  see  blood 
flow  from  his  fingers.  Thereafter  he  often  cut  or  pricked  himself  in 
the  fingers,  and  took  great  delight  in  it.  Very  early,  erections  were 
added  to  this,  and  also  if  he  saw  the  blood  of  others  ;  for  example,  when 
he  saw  a  servant-girl  cut  her  finger  it  gave  him  an  intense  lustful  feel- 
ing. From  this  time  his  vita  sexualis  became  more  and  more  powerful. 
Without  any  teaching  he  began  to  masturbate,  and  always  during  the 
act  there  were  memory-pictures  of  bleeding  girls.  It  now  no  longer 
sufficed  him  to  see  his  own  blood  flow ;  he  longed  to  see  the  blood  of 
young  females,  especially  those  that  were  attractive  to  him.  Often  he 
could  scarcely  overcome  the  impulse  to  injure  two  cousins  and  a  certain 
servant.  But  also  young  women  that  were  in  themselves  not  attractive 
induced  this  impulse  when  they  excited  him  by  some  peculiarity  of  dress 
or  adornment,  especially  coral  jewelry.      It  was  necessary  for  him  to 

1  Taxil  (op.  cit.)  gives  more  detailed  accounts  of  this  sexual  monster,  which  must 
have  been  a  case  of  habitual  satyriasis,  accompanied  by  perverse  sexual  instinct.  Sade 
was  so  cynical  that  be  actually  sought  to  idealize  his  cruel  lasciviousness,  and  become  the 
apostle  of  a  theory  based  upon  it.  He  became  so  bad  (among  other  things  he  made  an  in- 
vited company  of  ladies  and  gentlemen  erotic  by  causing  to  be  served  to  them  chocolate  bon- 
bons which  contained  cantharides)  that  he  was  committed  to  the  insane  asylum  at  Char- 
enton.  During  the  revolution  of  1790,  he  escaped.  Then  he  wrote  obscene  novels  filled 
with  lust,  cruelty,  and  the  most  obscene  scenes.  When  Bonaparte  became  Consul,  Sade 
made  him  a  present  of  his  novels  magnificently  bound.  The  Consul  had  the  works  de- 
stroyed, and  the  author  committed  to  Charenton  again,  where  he  died,  at  the  age  of  sixty- 
four. 


72  PSYCHOPATHIA   SEXTJALIS. 

overcome  these  desires ;  but  in  his  imagination  bloody  thoughts  were 
constantly  present,  and  induced  lustful  excitement.  There  was  an  inner 
relation  existing  between  both  thoughts  and  feelings.  Often  there 
were  other  cruel  fancies.  He  imagined  himself  in  the  role  of  a  tyrant 
who  had  the  people  shot  in  crowds  with  grape-shot.  He  was  compelled 
to  fancy  a  scene  as  it  would  be  if  enemies  were  to  take  a  city  and 
mutilate,  torture,  kill,  and  rape  the  young  women.  In  times  of  quiet  this 
patient,  who  had  a  mild  disposition  and  was  not  morally  defective,  Was 
shamed  and  horrified  by  such  cruel,  lustful  fancies,  and  they  always 
became  immediately  latent  as  soon  as  his  sexual  excitement  had  been 
satisfied  by  masturbation. 

After  a  few  years  the  patient  became  neurasthenic.  Then  simple 
imaginary  representation  of  blood  and  scenes  of  blood  was  sufficient 
to  induce  ejaculation.  In  order  to  free  himself  from  his  vice  and  his 
cruel  imagination,  he  began  to  indulge  in  sexual  intercourse  with  females. 
Coitus  was  possible,  but  only  when  the  patient  called  up  the  idea  that 
the  girl's  fingers  were  bleeding.  Without  the  assistance  of  this  idea  no 
erection  was  possible.  The  cruel  thought  of  cutting  was  limited  to  the 
woman's  hand.  At  times  of  greatest  sexual  excitement,  simply  the  sight 
of  the  hand  of  an  attractive  woman  was  sufficient  to  induce  violent  erec- 
tions. Frightened  by  the  popular  stories  about  the  injurious  results  of 
onanism,  he  abstained  and  fell  into  a  condition  of  severe  general  neuras- 
thenia, with  hypochondriacal  dysthymia  and  taedium  vitae.  Careful  and 
watchful  medical  treatment  cured  the  patient  after  a  few  months.  He  has 
remained  mentally  well  three  years  ;  but  now,  as  before,  he  is  very  sensual, 
though  it  is  very  seldom  that  he  is  troubled  by  his  earlier  bloody  ideas. 
X.  has  given  up  masturbation  entirely.  He  finds  satisfaction  in  natural 
sexual  indulgence,  is  virile,  and  it  is  no  longer  necessary  for  him  to  call 
up  ideas  of  blood. 

The  following  case,  reported  by  Tamowsky  (op.  cit,  p. 
61),  shows  that  such  lustful,  cruel  impulses  may  be  simply 
episodical,  and  occur  in  certain  exceptional  states  of  mind 
in  neurotic  individuals: — 

Case  25.  Z.,  physician ;  neuropathic  constitution,  reacting  badly 
to  alcohol.  Under  ordinary  circumstances  capable  of  normal  coitus,  as 
soon  as  he  has  indulged  in  wine  he  finds  that  his  increased  libido  is  no 
longer  satisfied  by  simple  coitus.  In  this  condition  he  is  compelled  to 
prick  the  nates  puellae  or  to  make  stabs  with  the  lancet,  to  see  blood, 
and  feel  the  entrance  of  the  blade  into  the  living  body,  in  order  to  have 
ejaculation  and  experience  complete  satiety  of  his  lust. 

The  majority  of  those  afflicted  with  this  form  of  the  perver- 
sion seem  insensible  to  the  normal  stimulus  of  woman.     In  the 


SADISM.  73 

first  case  (24),  the  assistance  of  the  idea  of  blood  was  necessary 
in  order  to  obtain  erection.  The  following  case  is  that  of  a  man 
who,  by  masturbation,  etc.,  in  early  youth,  had  diminished  his 
power  of  erection  so  that  the  sadistic  act  took  the  place  of  coitus : 

Case  26.  The  girl-stabber  of  Bozen  (reported  by  Demme,  "Buch 
cler  Yerbrechen,"  Bd.  ii,  p.  341).  In  1829,  H.,  aged  30,  soldier,  became 
the  subject  of  legal  investigation.  At  different  times  and  in  different 
places,  he  had  wounded  girls  with  bread-knives  or  pocket-knives,  by  stab- 
bing them  in  the  abdomen,  probably  in  the  region  of  the  genitals.  He 
gave,  as  a  motive  for  these  acts,  heightened  sexual  impulse,  increasing  to 
the  intensity  of  fury,  which  found  satisfaction  only  in  the  thought  and 
act  of  stabbing  persons  of  the  female  sex.  This  impulse  would  pursue 
him  for  days  at  a  time.  He  would  then  pass  into  a  confused  mental 
state,  which  would  clear  away  only  when  the  impulse  had  been  satisfied 
by  the  deed.  In  the  act  of  stabbing  he  had  a  satisfaction  like  that  of 
completed  coitus,  which  was  increased  by  the  sight  of  the  blood  that  ran 
from  the  knife.  In  his  tenth  year  the  sexual  instinct  became  powerfully 
manifest.  At  first  he  gave  himself  up  to  masturbation,  and  felt  physically 
and  mentally  weakened  by  it.  Before  he  became  a  girl-stabber  he  had 
satisfied  his  sexual  lust  in  violation  of  immature  girls,  by  causing  them 
to  practice  masturbation  on  him,  and  by  sodomy.  Gradually  the  thought 
came  to  him  of  how  pleasurable  it  would  be  to  stab  a  young  and  pretty 
girl  in  the  region  of  the  genitals,  and  take  delight  in  the  sight  of  the 
blood  running  from  the  knife. 

Among  his  effects  were  found  copies  of  objects  of  art  and  obscene 
pictures,  painted  by  himself,  of  Mary's  conception,  and  of  the  "  congealed 
thought  of  God  "  in  the  lap  of  the  Virgin.  He  was  considered  a  peculiar, 
very  irritable  man,  shy  of  people,  given  to  women,  moody,  and  glum. 
He  was  apparently  a  person l  that  had  become  impotent  through  earlier 
sexual  excesses,  and  who  was  thus  predisposed,  by  the  continuance  of 
intense  libido  sexualis,  and  heredity,  to  perversion  of  the  sexual  life. 

Case  27.  In  the  "  sixties  "  the  inhabitants  of  Leipzig  were  frightened 
by  a  man  who  was  accustomed  to  attack  young  girls  on  the  street  and 
stab  them  in  the  upper-arm  with  a  dagger.  Finally  arrested,  he  was 
recognized  as  a  sadist,  who,  at  the  instant  of  stabbing,  had  an  ejacula- 
tion, and  with  whom  the  wounding  of  the  girls  was  an  equivalent  for 
coitus.  (Wharton,  "A  Treatise  on  Mental  Unsoundness,"  §623.  Phila- 
delphia, 1873.) 2 

1  Comp.  Krauss,  Psychologic  dcs  Vcrbroclions,  1884,  p.  188 ;  Dr.  Hofer,  Annalen 
der  Staatsarzneikunde,  6  Jahrgang,  Heft  2  ;  Schmidt's  Jahrbiichcr,  Bd.  lix,  p.  94. 

2  According  to  newspaper  reports,  in  December,  1890,  several  similar  attacks  were 
made  in  Mainz.  A  young  fellow  between  fourteen  and  sixteen  years  old  pressed  against 
women  and  girls  and  stabbed  them  in  the  legs  with  a  sharp-pointed  instrument.  He  was 
arrested,  and  seemed  to  be  insane.     Further  details  of  the  case  are  not  known. 


74  PSYCHOPATHIA   SEXUALlS. 

Impotence  exists,  likewise,  in  the  next  three  cases.  It 
may  be  psychical,  however,  in  that  the  principal  tone  of  the  vita 
sexualis  lies  in  the  sadistic  inclination,  and  the  normal  elements 
are  distorted : — 

Case  28.  The  girl-cutter  of  Augsburg  (reported  by  Demme,  "  Buch 
der  Verbrechen,"  vii,  p.  281).  Bartle,  wine-merchant.  He  was  subject 
to  lively  sexual  excitement  at  the  age  of  fourteen,  though  decidedly 
opposed  to  its  satisfaction  by  coitus,  his  aversion  going  so  far  as  disgust 
for  the  female  sex.  At  that  time  he  already  had  the  idea  to  cut  girls, 
and  thus  satisfy  his  sexual  desire.  He  refrained  from  it,  however,  on 
account  of  lack  of  opportunity  and  courage.  He  practiced  masturbation, 
and  now  and  then  had  pollutions  with  erotic  dreams  of  girls  that  had 
been  cut.  At  the  age  of  nineteen  he  first  cut  a  girl.  During  the  act  he 
had  a  seminal  emission,  and  experienced  intense  pleasure.  From  that 
time  the  impulse  became  constantly  more  powerful.  He  chose  only 
3roung  and  pretty  girls,  and,  as  a  rule,  asked  them  before  the  deed 
whether  they  were  still  single.  The  ejaculation  or  sexual  satisfaction 
occurred  only  when  he  was  sure  that  he  had  actually  wounded  the  girls. 
After  such  an  act  he  always  felt  tired  and  bad,  and  was  also  troubled 
with  qualms  of  conscience.  Until  thirty-two  years  old  he  carried  on  this 
process  of  cutting,  but  always  with  care  not  to  wound  the  girls  dan- 
gerously. From  that  time  until  his  thirty-sixth  year  he  was  able  to 
control  his  impulse.  Then  he  sought  to  satisfy  himself  by  simply  press- 
ing the  girls  on  the  arm  or  neck ;  but  this  gave  rise  to  erections  and  not 
to  ejaculation.  Then  he  sought  to  attain  his  object  by  pricking  the  girls 
with  a  knife  in  its  sheath  ;  but  this  did  not  suffice.  Finally,  he  stabbed 
with  the  open  knife  and  had  complete  success,  for  he  thought  that  a  girl 
when  stabbed  bled  more  and  had  more  pain  than  one  that  was  merely 
cut.  In  his  thirty-seventh  year  he  was  detected  and  arrested.  In  his 
dwelling  was  found  a  collection  of  daggers,  sword-canes,  and  knives. 
He  said  that  the  mere  sight  of  these  weapons,  and  still  more  the  grasping 
of  them,  gave  him  an  intense  feeling  of  sensual  pleasure,  with  violent 
excitement.  According  to  his  confession  he  had  injured,  in  all,  fifty  girls. 
His  external  appearance  was  rather  pleasing.  He  lived  in  very  good 
circumstances,  but  was  peculiar  and  shy. 

Case  29.  J.  H.,  aged  25,  in  1883  came  for  consultation  concerning 
severe  neurasthenia  and  hypochondria.  Patient  confesses  that  he  has 
practiced  onanism  since  his  fourteenth  year,  infrequently  up  to  his 
eighteenth  year ;  but  since  that  time  he  has  been  unable  to  resist  the 
impulse.  Up  to  that  time  he  had  no  opportunity  to  approach  females, 
for  he  had  been  anxiously  cared  for  and  never  left  alone,  on  account  of 
his  invalidism.  He  had  had  no  real  desire  for  this  unknown  pleasure ; 
but  he  accidentally  learned  what  it  was  when  one  of  his  mother's  maids 


SADISM.  75 

cut  her  hand  severely  on  a  pane  of  glass  she  had  broken  while  washing 
windows.  While  helping  to  stop  the  blood  he  could  not  keep  from  suck- 
ing up  the  blood  that  flowed  from  the  wound,  and  in  the  act  he  experi- 
enced extreme  erotic  excitement,  with  complete  orgasm  and  ejaculation. 

From  this  time,  in  every  possible  way,  he  sought  to  see,  and  if 
possible  to  taste,  the  fresh  blood  of  females.  That  of  young  girls  was 
preferred  by  him.  He  spared  no  pains  or  expense  to  obtain  this  pleasure. 
At  first  he  availed  himself  of  a  young  servant  who  allowed  her  finger  to 
be  pricked  with  a  needle  or  lancet  at  his  request.  When  his  mother 
discovered  this,  she  discharged  the  girl.  Then  he  was  driven  to  prosti- 
tutes as  a  substitute,  with  success  frequently  enough,  though  with  some 
difficulty.  In  the  intervals  he  practiced  onanism  and  manustupration 
per  feminam,  which,  however,  never  afforded  him  complete  satisfaction, 
but,  on  the  contrary,  caused  listlessness  and  self-reproach.  On  account 
of  his  nervous  difficulties  he  visited  many  sanitariums,  and  he  was  twice 
a  voluntary  patient  in  institutions.  He  used  hydrotherapy,  electricity, 
and  strengthening  cures,  without  particular  success.  For  a  time  it  was 
possible,  by  means  of  cold  sitz-baths,  monobromate  of  camphor,  and 
bromides,  to  diminish  his  sexual  excitability  and  onanistic  impulse. 
However,  when  the  patient  felt  himself  free  again,  he  would  immediately 
fall  into  his  old  passions  and  spare  no  pains  or  money  in  order  to  satisfy 
his  sexual  desire  in  the  abnormal  manner  described. 

Case  30  (communicated  by  Dr.  A.  Moll,  Berlin).  L.  T.,  aged  21  ; 
merchant  in  a  Rhenish  city.  He  belongs  to  a  family  in  which  there  are 
several  nervous  and  ps3Tchopathic  members.  A  sister  suffers  with  hysteria 
and  melancholia. 

The  patient  was  always  of  quiet  disposition  and  timid.  At  school 
he  frequently  kept  apart  from  other  pupils,  particularly  when  they 
talked  about .  girls.  In  the  presence  of  ladies  he  thought  every  expres- 
sion he  made  was  an  offense  against  decency.  Thus,  for  example,  he 
thought  it  very  improper,  in  the  presence  of  ladies,  married  or  unmar- 
ried, to  speak  of  going  to  bed,  rising,  etc.  In  the  elementary  classes  the 
patient  learned  well.  Later  he  became  more  indolent  and  did  not  make 
good  progress. 

August  17,  1890,  the  patient  visited  Dr.  Moll  on  account  of  abnor- 
mal symptoms  of  a  sexual  kind.  He  did  this  on  the  advice  of  a  phy- 
sician, X.,  a  relative,  in  whom  he  had  previously  confided.  The  patient 
conveys  the  impression  of  being  very  apprehensive  and  shy,  and  in 
answer  to  questions  says  that  he  is  very  timorous,  and  that  particularly 
in  the  presence  of  others  all  his  self-confidence  and  assurance  leave  him. 
Dr.  X.  confirmed  this  statement. 

The  beginning  of  his  sexual  life  the  patient  was  able  to  refer  to 
his  seventh  year.  At  that  age  he  frequently  played  with  his  genitals, 
and  was  often  punished  for  it.  In  this  onanism,  in  which  he  said  he  had 
erection,  he   constantly  thought   of  whipping  a  woman   on  the   naked 


76  PSYCHOPATHIA   SEXtJALIS. 

nates  with  a  rod  until  the  skin  raised  in  weals.  "It  delighted  me," 
said  the  patient,  "  when  I  thought  that  she  was  a  proud,  beautiful  lady, 
and  that  I  performed  the  act  in  the  presence  of  others,  especially  women, 
particularly  with  the  idea  that  she  might  feel  the  power  I  Had  over  her. 
For  this  reason  I  early  sought  reading  about  punishment,  e.g.,  about  the 
abuse  of  Roman  slaves.  However,  I  had  erections  only  when  the  con- 
ceived abuse  consisted  of  blows  delivered  on  the  back  or  nates.  At  first 
I  thought  this  kind  of  excitement  would  disappear  in  time,  and  said 
nothing  about  it  to  any  one." 

Masturbation,  early  indulged  in,  the  patient  continued  to  practice, 
and  always  with  the  same  thought.  After  his  thirteenth  or  fourteenth 
year  he  had  ejaculation  with  the  act.  Decimum  septimum  annum  agens 
primum  feminam  adiit  coeundi  causa  neque  coitum  perficere  potuit  libidine 
et  erectione  deficientibus.  Mox  autem  iterum  apud  alteram  coitum  cona- 
tus  est  nullo  succesu.  Turn  feminam  per  vim  verberavit.  Tantopere  erat 
excitatus  ut  mulierem  dolore  clamantem  atque  lamentantem  verberare 
non  desierit.  He  never  thought  of  any  legal  punishment  for  his  acts, 
and,  in  fact,  escaped  it.  In  this  procedure  erection,  orgasm,  and 
ejaculation  occurred.  The  patient  performed  the  act  in  such  a  way  that 
he  took  the  woman  between  his  knees,  with  the  penis  in  contact  with 
her  body,  but  without  emissio  penis  in  vaginam,  which  seemed  entirely 
superfluous  to  him. 

But  the  patient  afterward  experienced  such  a  feeling  of  shame  about 
the  beating,  and  was  overcome  with  such  great  depression,  that  he  often 
contemplated  suicide.  In  the  following  three  years  he  still  visited 
women  occasionally.  But  he  never  again  asked  one  to  allow  him  to  beat 
her.  He  sought  to  obtain  erection  by  thinking  of  the  beating ;  but  this 
was  without  residt,  and  manustupration  \>y  the  woman  did  not  induce 
erection.  Finally,  after  an  unsuccessful  attempt  of  this  kind,  the  patient 
determined  to  give  his  confidence  to  a  plrysician. 

The  patient  made  several  other  statements  concerning  his  vita 
sexualis.  His  abnormal  sexual  desire  had  troubled  him  by  its  intensity. 
He  went  to  sleep  with  sexual  thoughts ;  they  troubled  him  through  the 
night  and  were  still  with  him  when  he  awoke.  He  was  never  safe  for  any 
length  of  time  from  the  impulsion  of  the  abnormal  ideas  that  excited 
him ;  to  which,  indeed,  he  gave  himself  up  willingly,  and  from  which  he 
could  free  himself  for  a  short  time  only  by  onanism. 

In  response  to  my  question,  the  patient  stated  that  any  other 
means  of  punishment  of  women  than  beating  the  back,  and  nates  particu- 
larly, had  no  charm  for  him.  Neither  binding  them,  walking  on  them,  nor 
striking  them,  gives  him  such  pleasure.  This  is  to  be  emphasized  the 
more,  since  the  whipping  given  the  woman  affords  him  sexual  pleasures 
because  its  effect  on  her  is  "  humiliating,  mortifying,"  and  because  she 
should  "  feel  that  she  is  completely  in  his  power."  Too,  it  would  give 
the  patient  no  pleasure  to  beat  a  woman  on  any  other  part  of  her  body 


SADISM.  77 

than  those  mentioned,  or  to  cause  her  pain  in  any  other  way  than  by 
blows.  Multum  minorem  ei  affert  voluptatem  si  nates  suae  a  muliere 
verberantur ;  tamen  ea  res  saepe  ejaculationem  seminis  effecit,  sed  haec 
fieri  putat  erectione  deficienti.  Inter  verbera  autem  penem  in  vaginam 
immittendo  nullam  voluptatem  se  habere  ratus  qualibet  parte  corporis 
feminae  pene  tacte  semen  ejaculat.  Just  as  in  beating  the  woman  his 
pleasure  lay  in  humiliating  her,  so  with  the  relations  reversed  he  was 
sexually  excited  by  the  fact  that  the  beating  humiliated  him  and  he  felt 
himself  to  be  completely  in  the  woman's  power.  No  other  personal  humilia- 
tion than  a  beating  on  his  nates  could  excite  him.  To  allow  himself  to 
be  bound  or  walked  on  b}r  a  woman  is  repugnant  to  him. 

The  patient's  dreams,  as  far  as  they  were  of  an  erotic  nature,  were 
directed  in  the  same  way  as  his  sexual  inclinations  while  awake ;  actual 
ejaculation  also  often  took  place  in  dreams.  Whether  the  perverse  sexual 
thoughts  first  occurred  in  dreams  or  the  waking  state,  the  patient  is  not 
able  to  state,  owing  to  the  fact  that  his  memory  goes  back  so  far, — to  his 
seventh  year.  But  he  thinks  that  these  thoughts  first  occurred  to  him 
while  awake.  In  his  dreams  it  frequently  seemed  to  him  that  he  was 
striking  a  man,  which  also  caused  ejaculation.  In  the  waking  state  it 
excited  him  but  very  little  to  think  of  striking  a  man.  The  nude  form  of 
a  man  had  no  attraction  whatever  for  him,  while  the  nude  form  of  a  woman 
had  a  decided  charm  for  him,  though  his  libido  found  its  real  satisfaction 
only  when  the  acts  previously  described  took  place ;  and,  as  he  states,  he 
feels  no  desire  for  coitus  in  vaginam. 

The  treatment  of  the  patient  is  directed  to  the  attainment  of  normal 
coitus  with  normal  desire,  where  possible ;  for  it  may  be  assumed  that, 
with  success  in  making  his  sexual  life  normal,  the  patient's  shyness  and 
apprehensiveness,  which  cause  him  great  annoyance,  may  be  much  easier 
removed.  The  treatment  followed  by  me  (Dr.  Moll)  during  three  months 
and  a  half  was  as  follows : — 

1.  The  patient,  who  had  a  great  desire  to  be  cured,  was  most 
strictly  forbidden  to  give  himself  up  to  the  perverse  thoughts.  Of  course, 
I  did  not  give  him  the  foolish  advice  not  to  think  of  blows  at  all.  The 
patient  could  not  follow  such  advice,  since  the  thoughts  come  to  him 
without  any  act  of  his  own,  even  when  he  accidentally  reads  the  word 
"  blow  "  (schlagen).  I  forbade  him  only  ever  to  voluntarily  give  himself 
to  such  thoughts.  I  advised  him  more  particularly  to  do  everything  in 
order  to  turn  his  ideas  in  another  direction. 

2.  I  allowed  him,  commanded  him  even,  to  think  of  nude  women, 
because  many  nude  females  interested  him,  even  though,  as  he  thought, 
they  did  not  excite  him  sexually. 

3.  I  sought,  by  means  of  hypnosis — which  was  hard  to  induce — 
and  suggestion,  to  fortify  the  patient  in  this  as  far  as  possible.  All 
attempts  at  coitus  were  forbidden  in  order  to  save  the  patient  from  a 
discouraging  result. 


78  PSYCHOPATHIA    SEXUALIS. 

Within  two  months  and  a  half  this  treatment  led  to  the  result  that, 
as  the  patient  stated,  the  perverse  ideas  occurred  much  less  frequently 
and  were  constantly  retreating  to  the  background  ;  indeed,  according  to 
the  patient's  statement,  erections  occurred  with  the  thoughts  of  nude 
women,  became  more  frequent,  and  often  induced  him  to  masturbate  with 
the  thought  of  coitus  without  the  occurrence  of  any  idea  of  blows. 
Erotic  dreams  occurred  but  infrequently.  These  were  concerned  some- 
times with  normal  coitus,  sometimes  with  blows. 

After  two  months  and  a  half  of  the  treatment  I  advised  the  patient 
to  attempt  coitus.  Since  then  he  has  tried  four  times.  I  advised  him  to 
choose  always  a  woman  who  pleased  him,  and  sought  to  increase  his 
sexual  excitement  before  coitus  by  means  of  tincture  of  cantharides. 
The  four  attempts,  the  last  of  which  took  place  on  November  29,  1890, 
resulted  as  follows :  At  the  first,  prolonged  manipulation  of  the  penis  by 
the  woman  Was  necessary  in  order  to  induce  erection.  Then  immisio  in 
vaginam  and  ejaculation  with  orgasm  took  place.  During  the  whole  act 
there  occurred  no  thought  of  beating  the  woman  or  being  beaten,  but  the 
woman  in  herself  excited  him  sufficiently  for  the  performance  of  coitus. 
At  the  second  attempt  the  result  was  better  and  more  quickly  attained  ; 
manipulation  ad  genitalia  by  the  woman  was  not  long  required.  In  the 
third  attempt  coitus  was  attained  only  after  the  patient  had  thought  of 
beating  for  a  long  time,  and  had  thus  induced  erection  ;  but  beating  was 
not  indulged  in.  At  the  fourth  attempt  coitus  was  attained  without 
any  thought  of  beating  and  without  any  manipulation  ad  genitalia. 

Of  course,  the  case  described  cannot  yet  be  regarded  in  any  way  as 
cured.  Though  the  patient  were  able  to  perform  coitus  in  a  normal  or 
nearly  normal  way,  that  does  not  mean  that  he  will  always  be  able  to 
do  it  in  the  future ;  moreover,  the  thought  of  beating  still  affords  him 
great  pleasure,  even  though  it  occurs  much  less  frequently  than  for- 
merly. Yet  there  is  a  possibility  that  the  abnormal  desire,  which 
has  been  weakened,  will  remain  weakened  in  the  future,  and  perhaps 
disappear. 

This  carefully  observed  case  is,  for  several  reasons,  particu- 
larly interesting.  It  discloses  clearly  one  of  the  hidden  roots 
of  sadism, — the  impulse  to  complete  subjugation  of  the  woman, 
which  here  became  consciously  entertained.  This  is  the  more 
remarkable  since  it  occurred  in  an  individual  decidedly  timid, 
and  in  other  respects  modest  and  even  apprehensive.  The  case 
also  shows  clearly  that  powerful  libido,  which  even  impels  the 
individual  to  overcome  all  obstacles,  may  be  present,  while  at 
the  same  time  coitus  is  not  desired,  because  the  principal  inten- 
sity of  feeling  is,  ab  origine,  connected  with  the  cruel  part  of 


SADISM.  79 

the  sadistic  (lustful  and  cruel)  circle  of  ideas.  This  case  also 
contains  weak  elements  of  masochism  (v.  infra). 

Cases  are  by  no  means  infrequent  in  which  men  with 
perverse  inclinations  induce  prostitutes,  by  paying  them  high 
prices,  to  allow  themselves  to  be  whipped  and  even  wounded 
by  them.  Works  on  prostitution  contain  reports  of  them  (vide 
Coffignon,  "  La  Corruption  a  Paris,"  etc.). 

(d)  Defilement  of  Women. — The  perverse  sadistic  impulse, 
to  injure  women  and  put  contempt  and  humiliation  upon  them, 
is  also  expressed  in  the  desire  to  defile  them  with  disgusting  or, 
at  least,  foul  things. 

The  following  case,  published  by  Arndt  (  Vierteljalirsschr. 
f.  ger.  Medicin,  N.  F.  xvii,  H.  1),  belongs  here: — 

Case  31.  A.,  medical  student  at  Greifswald,  accusatus  quod  iterum 
iterumque  puellis  honestis  parentibus  natis  in  publico  genitalia  sua  e 
bracis  dependentia  plane  nudata  quae  antia  summo  amiculo  (overcoat) 
tecta  erant,  ostenderat.  Nonnunquam  puellas  fugientes  secutus  easque 
ad  se  attractas  urina  oblivit.  Haec  luce  clara  facta  sunt ;  nunquam  aliquid 
haec  faciens  locutus  est. 

A.  is  twenty-three  years  old,  powerfully  built,  neat  in  dress,  and 
decent  in  manners.  Indication  of  cranium  progeneum ;  chronic  pneu- 
monia of  the  apex  of  the  right  lung ;  emphysema.  Pulse,  60  ;  in  excite- 
ment, not  more  than  70  to  80.  Genitals  normal.  Complaints  of  occa- 
sional disturbances  of  digestion  and  hardness  of  the  abdomen,  vertigo ; 
excessive  excitement  of  the  sexual  desires,  which  early  led  to  onanism. 
The  sexual  desire  has  never  been  directed  toward  a  natural  method  of 
satisfaction.  Complaints  of  occasional  attacks  of  depression,  or  thoughts 
of  deprecation  of  self,  and  of  perverse  impulses,  for  which  he  could  find 
no  motive  ;  such  as  laughing  at  serious  things,  throwing  his  money  in  the 
water,  and  running  about  in  the  pouring  rain.  The  father  of  the  culprit 
is  of  a  nervous  temperament ;  his  mother  is  subject  to  nervous  headache. 
A  brother  suffered  with  epileptic  convulsions. 

From  his  youth  the  culprit  presented  a  nervous  temperament, 
was  inclined  to  convulsions  and  attacks  of  syncope,  and  when  he  was 
severely  scolded  would  fall  into  a  state  of  momentary  stiffness.  In  1869 
he  studied  medicine  in  Berlin.  In  1810  he  went  to  the  war  as  a  hospital- 
assistant.  His  letters  at  this  time  betray  a  peculiar  torpidity  and  weak- 
ness. On  his  return  home,  in  1871,  his  emotional  irritability  was  noticed 
by  those  about  him.  Thereafter  frequent  complaints  of  bodily  ailments ; 
unpleasantness  resulting  from  a  love  affair.  In  November,  1871,  he 
pursued  his  studies  diligently  in  Greifswald.     He  was  considered  very 


80  PSYCHOPATHIA   SKSUALIS. 

gentlemanly.  In  confinement  he  is  quiet,  calm,  and  sometimes  self- 
absorbed.  His  acts  he  attributes  to  painful  sexual  excitement,  which  of 
late  had  become  excessive.  He  declared  that  he  had  been  fully  conscious 
of  his  perverse  acts,  and  had  afterward  been  ashamed  of  them.  He 
had  not  experienced  actual  sexual  satisfaction  in  their  commission.  He 
obtained  no  correct  insight  into  his  position.  He  considered  himself  a 
kind  of  martyr, — fallen  a  victim  to  an  evil  power.  Presumption  of 
irresponsibility,  as  a  result  of  absence  of  free  will. 

The  impulse  to  defile  occurs  also,  paradoxically,  in  the 
aged,  when  there  is  a  re-appearance  of  sexual  instinct,  which, 
under  such  circumstances,  is  so  often  expressed  in  perverse 
acts.     Thus  Tarnowsky  reports  (p.  76)  the  following  case : — 

Case  32.  I  knew  such  a  patient,  who  had  a  woman  dressed  in  a 
decollete  ball-dress  lie  down  on  a  low  sofa  in  a  brightly  lighted  room.  Ipse 
apud  januam  alius  cubiculi  obscurati  constitit  adspiciendo  aliquantulum 
feminam,  excitatus  in  earn  insiluit  excrementa  in  sinus  ejus  deposuit. 
Haec  faciens  ejaculationem  quandam  se  sentire  confessus  est. 

An  officer  of  Vienna  informs  me  that  men,  by  means  of 
large  sums  of  money,  induce  prostitutes  to  suffer  ut  illi  viri  in 
ora  earum  spuerent  et  faeces  et  urinas  in  ora  explerent.1 

The  following  case  by  Dr.  Pascal  ("  Igiene  dell'  amore  ") 
seems  also  to  belong  here : — 

Case  33.  A  man  had  an  inamorata.  His  relation  with  her  was  that 
he  had  her  allow  him  to  blacken  her  hands  with  coal  or  soot,  and  then  she 
had  to  sit  before  a  mirror  in  such  a  way  that  he  could  see  her  hands 
in  it.  While  conversing  with  her,  which  was  often  for  a  long  time,  he 
looked  constantly  at  her  mirrored  hands,  and  finally,  after  a  time,  he 
would  take  his  leave,  fully  satisfied. 

The  following  case,  communicated  by  a  physician,  may  be 
of  interest  in  relation  to  this  subject : — 

An  officer  was  known  in  a  brothel  in  K.  only  by  the  name  of  "  Oil." 
"  Oil "  induced  erection  and  ejaculation  only  by  having  puell.  publ.  nudam 
step  into  a  tub  filled  with  oil,  while  he  rubbed  the  oil  all  over  her  body. 

These  acts  lead  to  the  presumption  that  certain  cases 
of  injury  of  females  {e.g.,  sprinkling  with  sulphuric  acid,  ink, 

1  Leo  Taxil  (La  Corruption,  Paris,  Noiret,  p.  223)  makes  the  same  statements. 
There  are  also  men  who  demand  introductio  linguae  meretricis  in  anum. 


SADISM.  81 

etc.)  depend  upon  a  perverse  sexual  impulse ;  at  least,  here  it  is 
a  kind  of  injury,  and  those  injured  are  always  females,  and  the 
perpetrators  males.  At  least  in  the  future,  in  crimes  of  this  kind, 
pains  should  be  taken  to  examine  the  vita  sexualis  of  the 
culprits. 

The  case  of  Bachmann,  given  below,  throws  a  clear  light 
on  the  sexual  nature  of  such  crimes;  for,  in  this  case,  the 
sexual  motive  in  the  deed  is  proven. 

(e)  Other  Attacks  on  Females — Symbolic  Sadism. — The 
foregoing  groups  do  not  exhaust  the  forms  in  which  the  sadistic 
impulse  toward  women  is  expressed.  If  the  impulse  is  not 
overmastering,  or  there  is  yet  sufficient  moral  resistance,  it 
may  happen  that  the  perverse  inclination  is  satisfied  by  an  act 
that  is  apparently  quite  senseless  and  silly,  but  which  has  a 
symbolic  meaning  for  the  perpetrator.  This  seems  to  be  the 
meaning  of  the  two  following  cases : — 

Case  34.  (Dr.  Pascal, "  Igiene  dell'  amore.")  A  man  was  accustomed 
to  go,  on  a  certain  day  once  a  month,  to  an  inamorata  and  cut  her  "  bang." 
This  gave  him  the  greatest  pleasure.  He  made  no  other  demands  on 
the  girl. 

Case  35.  A  man  in  Vienna  regularly  visits  several  prostitutes  only 
to  lather  their  faces  and  then  to  remove  the  lather  with  a  razor,  as  if  he 
were  shaving  them.  He  never  hurts  the  girls,  but  becomes  sexually 
excited  and  ejaculates  during  the  procedure. 

The  significance  of  the  following  cases,  in  which  a  sadistic 
comedy  is  played,  is  clearer : — 

Case  36.  A  man  always  announces  to  a  puella  publica  his  intended 
visits.  She  must  stand  at  the  window,  awaiting  him,  with  her  face  done 
up,  and,  on  his  entrance  into  the  room,  complain  of  severe  toothache. 
He  is  sorry  for  her,  asks  particularly  about  the  pain,  takes  the  cloth  off 
and  puts  it  on  again  ;  but  he  never  has  coitus,  and  finds  his  satisfaction 
simply  in  this  act.1 

The  following  case,  which,  unfortunately,  was  not  carefully 
examined  scientifically,  is  peculiar  to  itself: — 

1  Leo  Taxil  (op.  cit.,  p.  224)  relates  that  in  Parisian  brothels  instruments  are  kept 
ready  which  look  like  knouts,  but  which  are  merely  tubes  filled  with  air,  6uch  as  clowns 
use  in  circuses.  Sadistic  men  use  them  to  create  for  themselves  the  illusion  that  they  are 
whipping  women. 

6 


82  PSYCOPATHIA   SEXUALIS. 

Iu  an  examination  before  a  criminal  court  in  Vienna,  the  follow- 
ing facts  were  brought  to  light :  Count  N.,  accompanied  by  a  young 
girl,  appeared  in  the  public  garden  of  an  hotel,  and,  by  his  actions  there, 
gave  public  offense.  He  demanded  of  his  companion  that  she  kneel  down 
before  him  and  implore  him  with  folded  hands.  Then  she  was  compelled 
to  lick  his  boots.  Finally,  he  demanded  of  her,  publicly,  "  an  unheard- 
of  thing  "  (osculum  ad  nates,  or  the  like),  and  only  desisted  after  she  had 
sworn  to  do  it  at  home. 

In  this  case,  the  most  remarkable  thing  was  the  desire  of 
the  perverse  individual  to  humiliate  the  woman  before  witnesses 
(comp.  the  fancies  of  sadists,  Case  29) ;  further,  that  the  desire 
to  humiliate  the  woman  came  entirely  into  the  foreground,  and 
acts  of  a  purely  symbolic  nature  were  undertaken.  Of  course, 
with  these,  in  this  imperfectly-observed  case,  acts  of  cruelty 
were  probable. 

(f)  Sadism  icith  Other  Objects — Whipping  of  Boys. — 
Besides  the  sadistic  acts  with  females  described,  others  occur 
with  other  living,  sensitive  objects, — children  and  animals. 
There  may  be  a  full  consciousness  that  the  impulse  is  really 
directed  toward  women,  and  that  only  faute  cle  mieux  the  next 
attainable  objects  (pupils)  are  abused.  But  the  condition  of  the 
perpetrator  may  be  such  that  the  impulse  to  cruel  acts  enters 
consciousness  accompanied  only  by  lustful  excitement,  while  its 
real  object  (which  alone  can  explain  the  lustful  coloring  of  such 
acts)  remains  in  the  dark. 

The  first  alternative  suffices  as  an  explanation  of  the  cases 
which  Dr.  Albert  describes  (Friedreich's  Blatter  f.  ger.  Med., 
p.  77,  1859), — cases  in  which  lustful  teachers  whipped  their 
pupils  on  the  naked  nates  without  cause.  We  must  think  of 
the  second  alternative,  the  sadistic  impulse  with  unconsciousness 
of  its  object,  when  boys  are  immediately  excited  sexually  at  the 
sight  of  punishment  of  their  companions,  and  are  thus  deter- 
mined in  their  later  vita  sexualis,  as  in  the  following  cases : — 

Case  37.  K.,  aged  3T,  merchant,  applied  to  me  in  the  fall  of  1889 
for  advice  concerning  an  anomaly  of  his  vita  sexualis,  which  made  him 
fear  invalidism  and  impossibility  of  future  happiness  in  marriage. 

Patient  came  of  a  nervous  family.  As  a  child  he  was  delicate,  weak, 
and  nervous.     Healthy  except  for  measles ;  he  later  became  strong. 


SADISM.  83 

At  the  age  of  eight,  while  at  school,  he  saw  how  the  teacher  pun- 
ished the  boys  by  taking  their  heads  between  his  thighs  and  spanking 
them  with  a  ferule.  This  sight  caused  the  patient  lustful  excitement. 
M  Without  an}-  idea  of  the  danger  and  enormity  of  onanism,"  he  satisfied 
himself  with  it,  and  from  that  time  often  masturbated,  during  which  he 
always  called  up  the  memory-picture  of  a  boy  being  punished. 

Thus  it  continued  until  his  twentieth  year.  Then  he  learned  the 
significance  of  onanism,  was  terribly  frightened,  and  tried  to  overcome 
his  impulse  to  masturbate ;  but  he  fell  into  the  practice  of  psychical 
onanism,  which  he  regarded  as  innocuous  and  morally  defensible,  and 
for  which  he  made  use  of  the  memory-pictures  of  bo3's  being  whipped, 
previously  mentioned. 

Patient  now  became  neurasthenic,  suffered  with  pollutions,  and 
tried  to  cure  himself  by  visiting  brothels ;  but  he  could  not  induce  erec- 
tion. Then  he  sought  to  obtain  normal  sexual  feelings  by  means  of  social 
intercourse  with  ladies ;  but  he  recognized  that  he  was  entirely  insensible 
to  the  charms  of  the  fair  sex. 

The  patient  is  an  intelligent  man,  normally  developed,  and  of 
aesthetic  taste.  There  is  no  inclination  to  persons  of  his  own  sex.  My 
advice  consisted  of  means  to  combat  the  neurasthenia  and  pollutions ; 
interdiction  of  psychical  and  manual  onanism ;  avoidance  of  all  sexual 
excitants ;  and,  possibly,  hypnotic  treatment  to  ultimately  induce  a  return 
of  the  vita  sexualis  to  its  normal  condition. 

Case  38.  Abortive  sadism.  N.,  student,  came  under  observation 
in  December,  1890.  He  had  practiced  masturbation  from  early  3'outh. 
According  to  his  statements,  he  became  sexually  excited  when  he  saw  his 
father  whip  the  children,  and,  later,  when  he  saw  the  teacher  whip  his 
companions.  When  a  spectator  of  such  scenes,  he  always  experienced 
lustful  feelings.  He  could  not  say  exactly  when  this  first  occurred,  but 
it  may  have  been  at  about  the  age  of  six.  He  could  not  tell  exactly  when 
he  began  to  masturbate,  but  he  stated  with  certainty  that  his  sexual 
instinct  was  first  awakened  by  the  punishment  of  others,  and  thus  he  un- 
consciously came  to  practice  onanism.  The  patient  remembered  clearly 
that  from  the  age  of  four  to  the  age  of  eight  he  Avas  frequently  sjmiked, 
and  that  this  caused  him  pain,  never  lustful  pleasure. 

Since  he  did  not  always  have  opportunity  to  see  others  whipped,  he 
began  to  imagine  how  others  were  punished.  This  excited  his  lust,  and 
he  would  then  masturbate.  Whenever  he  could,  he  managed  to  see  others 
punished  at  school.  Now  and  then  he  also  felt  desire  to  whip  others.  At 
the  age  of  twelve  he  induced  a  comrade  to  allow  him  to  whip  him.  He 
found  great  sexual  pleasure  in  it.  When,  however,  his  companion  beat 
him  in  return,  he  experienced  nothing  but  pain. 

The  impulse  to  beat  others  was  never  very  strong.  The  patient  ex- 
perienced more  satisfaction  in  filling  his  imagination  wTith  scenes  of  whip- 
ping.    He  never  indulged  in  any  other  sadistic  acts,  and  never  had  any 


84  PSYCHOPATHIA   SEXUALIS. 

desire  to  see  blood,  etc.  Until  his  fifteenth  year  his  sexual  indulgence 
consisted  of  onanism,  indulged  in  after  such  fancies.  After  that  (dancing 
lessons,  association  with  girls),  the  early  fancies  disappeared  almost  en- 
tirely, and  were  accompanied  by  but  weak  lustful  feelings ;  so  that  the 
patient  gave  them  up  entirely.  In  their  place  came  thoughts  of  coitus 
in  a  natural  way,  without  anything  sadistic. 

The  patient  indulged  in  coitus  for  the  first  time  "on  account  of 
his  health."  He  then  tried  to  abstain  from  onanism,  but  was  not  success- 
ful, though  he  often  indulged  in  coitus,  and  with  more  pleasure  than  he 
had  in  onanism.  He  wished  to  be  freed  from  onanism  as  something 
vicious.  He  had  coitus  once  a  month,  but  masturbated  once  or  twice 
every  night.  He  was  normal  sexually,  with  the  exception  of  the  onanism. 
There  was  no  neurasthenia ;  genitals  normal. 

Case  39.  P.,  aged  15,  of  high  social  position,  came  of  an  hysterical 
mother,  whose  brother  and  father  died  in  an  asylum.  Two  children  of  the 
family  died,  in  early  childhood,  of  convulsions.  The  patient  is  talented, 
virtuous,  and  quiet ;  but  at  times  he  is  very  disobedient,  stubborn,  and 
passionate.  He  has  epilepsy,  and  practices  onanism.  One  day  it  was 
learned  that  P.,  with  money,  induced  a  comrade  of  fourteen,  B.,  to  allow 
himself  to  be  pinched  on  the  arm,  back,  and  thigh.  When  B.  cried,  P. 
became  excited  and  struck  at  B.  with  his  right  hand,  while  with  his  left 
he  made  manipulations  in  the  left  pocket  of  his  trousers.  P.  confessed 
that  to  maltreat  his  friend,  of  whom  he  was  very  fond,  gave  him  peculiar 
delight ;  and  that  ejaculation  while  hurting  his  friend  gave  him  much 
more  pleasure  than  when  he  masturbated  alone,  (v.  Gyurkovechky, 
"  Pathol,  und  Therapie  der  mannl.  Impotenz.,"  p.  80,  1889.) 

That  in  all  these  cases  of  sadistic  abuse  of  boys  there  can 
be  no  thought  of  a  combination  of  sadism  and  contrary  sexual 
instinct,  as  often  occurs  {v.  infra)  in  individuals  of  contrary 
sexuality,  is  shown — aside  from  the  absence  of  all  positive  signs 
of  it — by  a  study  of  the  next  group,  where,  in  association  with 
the  object  of  injury, — animals, — the  instinct  for  women  is  seen 
to  appear  repeatedly. 

(g)  Sadistic  Acts  with  Animals. — In  numerous  cases,  sadist- 
ically perverse  men  that  are  afraid  of  criminal  acts  with  human 
beings,  or  that  care  only  for  the  sight  of  the  suffering  of  a  sen- 
sitive being,  make  use  of  the  sight  of  dying  animals,  or  torture 
animals,  to  stimulate  or  excite  their  lust. 

The  case  of  a  man  in  Vienna,  which  is  reported  by  Hofmann  in 
his  "  Text-Book  of  Legal  Medicine,"  is  noteworthy  in  relation  to  this. 
According  to  the  evidence  of  several  prostitutes,  before  the  sexual  act  he 


SADISM.  85 

was  accustomed  to  excite  himself  by  torturing  chickens  and  pigeons  and 
other  birds,  and,  therefore,  was  called  "  Hendlmann  "  (chicken). 

For  the  elucidation  of  such  cases  the  observation  of  Lombroso  is 
of  value,  according  to  whom  two  men  had  ejaculation  when  they  killed 
chickens  or  pigeons,  or  wrung  their  necks. 

The  same  author,  in  his  "  Uomo  delinquente,"  p.  201,  speaks  of  a 
poet  of  some  reputation,  who  became  powerfully  excited  sexually 
whenever  he  saw  calves  slaughtered,  and  also  at  the  sight  of  bloody 
flesh. 

According  to  Mantegazza  (op.  ct7.,p.  114), among  degenerate  China- 
men, a  horrible  sport  consists  of  committing  sodomy  with  geese,  and 
cutting  their  necks  off  tempore  ejaculationis  ! 

Mantegazza  ("  Fisiologia  del  piacere,"  5th  ed.,  pp.  394,  395)  men- 
tions the  case  of  a  man  who  once  saw  chickens  killed,  and  from  that 
time  had  a  desire  to  wallow  in  their  warm,  steaming  entrails,  because  he 
experienced  a  feeling  of  lust  while  doing  it. 

Thus,  in  these  and  similar  cases,  the  vita  sexualis  is  so 
constituted  ab  origine  that  the  sight  of  blood,  death,  etc.,  excites 
lustful  feeling.     It  is  so  in  the  following  case : — 

Case  40.  C.  L.,  aged  42,  engineer,  married,  father  of  two  children ; 
from  a  neuropathic  family  ;  father  irascible,  a  drinker ;  mother  hysterical, 
subject  to  eclamptic  attacks.  The  patient  remembers  that  in  childhood 
he  took  particular  pleasure  in  witnessing  the  slaughtering  of  domestic 
animals,  especially  swine.  He  thus  experienced  lustful  pleasure  and 
ejaculation.  Later  he  visited  slaughter-houses,  in  order  to  delight  in  the 
sight  of  flowing  blood  and  the  death  throes  of  the  animals.  When  he 
could  find  opportunity,  he  killed  the  animals  himself,  which  always  afforded 
him  a  vicarious  feeling  of  sexual  pleasure. 

At  the  time  of  full  maturity  he  first  attained  to  a  knowledge  of  his 
abnormality.  The  patient  was  not  exactly  opposed  in  inclination  to 
women,  but  close  contact  with  them  seemed  to  him  repugnant.  On  the 
advice  of  a  physician,  at  twenty-five  he  married  a  woman  who  pleased 
him,  in  the  hope  of  freeing  himself  of  his  abnormal  condition.  Although 
he  was  very  partial  to  his  wife,  it  was  only  seldom,  and  after  great  trouble 
and  exertion  of  his  imagination,  that  he  could  perform  coitus  with  her ; 
nevertheless,  he  begat  two  children.  In  1866  he  was  in  the  war  in 
Bohemia.  His  letters  written  at  that  time  to  his  wife,  were  composed  in 
an  exalted,  enthusiastic  tone.     He  was  killed  in  the  battle  of  Koniggratz. 

If,  in  this  case,  the  capability  of  normal  coitus  was  much 
impaired  by  the  predominance  of  perverse  ideas,  in  the  next  it 
seems  to  have  been  entirely  repressed : — 


86  PSYCHOPATHIA   SEXUALlS. 

Case  41.  (Dr.  Pascal,  "  Igiene  dell'  amore.")  A  gentleman  visited 
prostitutes,  had  them  purchase  a  living  fowl  or  rabbit,  and  required  them 
to  torture  the  animal.  He  had  in  mind  the  head  and  tearing  out  the 
eyes  and  entrails.  If  he  found  a  girl  who  would  consent,  and  go  about 
it  right  cruelly,  he  was  delighted,  and  paid  her  and  went  his  way  without 
asking  anything  more  or  touching  her. 

The  last  two  sections  show  that  the  suffering  of  any  living 
being  may  become  a  source  of  perverse  sexual  enjoyment  to 
sadistically  constituted  persons,  and  that  there  may  be  sadism 
with  almost  any  [living]  object.  However,  it  would  be  errone- 
ous and  an  exaggeration  to  try  to  explain  by  sadistic  perversion 
all  the  remarkable  and  surprising  acts  of  cruelty  that  occur ; 
and,  in  the  innumerable  cruelties,  as  they  here  and  there  occur 
in  history  or  in  certain  psychological  manifestations  among  the 
people  at  the  present  time,  it  would  be  erroneous  to  assume 
sadism  as  a  motive. 

Cruelty  arises  from  various  sources,  and  is  natural  to  primi- 
tive man.  Compassion,  in  contrast  with  it,  is  a  secondary 
manifestation,  and  acquired  late.  The  instinct  to  fight  and 
destroy,  so  important  an  endowment  in  prehistoric  conditions, 
is  long  afterward  operative ;  and,  in  the  ideas  engendered  by 
civilization,  like  that  of  "  the  criminal,"  it  finds  new  objects, 
even  though  its  original  object — "  the  enemy  " — still  exists. 
That  not  simply  the  death,  but  also  torture,  of  the  conquered  is 
demanded,  is  in  part  explained  by  the  sense  of  power,  which 
satisfies  itself  in  this  way ;  and  in  part  by  the  insatiableness  of 
the  impulse  of  vengeance.  Thus  all  cruelty  and  all  historical 
enormities  may  be  explained  without  recourse  to  sadism  (which 
may  often  have  been  in  operation,  but  which  cannot  be  assumed, 
since  it  is  relatively  an  infrequent  perversion). 

At  the  same  time,  there  is  still  another  powerful  psychical 
element  to  take  into  consideration,  which  explains  the  attraction 
that  is  still  exerted  by  executions,  etc. ;  and  that  is,  the  pleasure 
there  is  in  intense  and  unusual  impressions  and  rare  sights,  in 
contrast  with  which,  in  coarse  and  blunted  beings,  pity  is  silent. 

But  undoubtedly  there  are  individuals  for  whom,  in  spite 
of,  or  even  by  reason  of,  their  lively  compassion,  all  that  is  con- 


SADISM.  87 

nected  with  death  and  suffering  has  a  mysterious  attraction ; 
who,  with  inward  opposition,  and  yet  following  a  dark  impulse, 
occupy  themselves  with  such  things,  or  at  least  with  pictures  and 
notices  of  them.  Still,  this  is  not  sadism,  as  long  as  no  sexual 
element  enters  into  consciousness ;  and  yet  it  is  possible  that,  in 
unconscious  life,  slender  threads  connect  such  manifestations 
with  the  hidden  depths  of  sadism. 

(h)  Sadism  in  Woman. — That  sadism — a  perversion,  as 
we  have  seen,  frequent  in  men — is  much  less  frequent  in  women, 
is  easily  explained.  In  the  first  place,  sadism,  in  which  the 
need  of  subjugation  of  the  opposite  sex  forms  a  constituent 
element,  in  accordance  with  its  nature,  represents  a  pathological 
intensification  of  the  masculine  sexual  character ;  in  the  second 
place,  the  obstacles  which  oppose  the  expression  of  this  mon- 
strous impulse  are,  of  course,  much  greater  for  a  woman  than 
for  a  man.  Yet  sadism  occurs  in  women ;  and  it  can  only  be 
explained  by  the  primary  constituent  element, — the  general 
hyper-excitation  of  the  motor  sphere.  Only  two  cases  have  thus 
far  been  scientifically  studied. 

Case  42.  A  married  man  presented  himself  with  numerous  scars 
of  cuts  on  his  arms.  He  told  their  origin  as  follows :  When  he  wished 
to  approach  his  wife,  who  was  young  and  somewhat  "  nervous,"  he  first 
had  to  make  a  cut  in  his  arm.  Then  she  would  suck  the  wound,  and 
during  the  act  become  violently  excited  sexually.    . 

This  case  recalls  the  wide-spread  legend  of  the  vampires, 
the  origin  of  which  may  perhaps  be  referred  to  such  sadistic 
facts.1 

In  a  second  case  of  feminine  sadism,  for  which  I  am 
indebted  to  Dr.  Moll,  of  Berlin,  by  the  side  of  the  perverse  im- 
pulse, as  so  frequently  occurs,  there  is  anaesthesia  for  the  nor- 
mal activities  of  the  sexual  life ;  and  here  there  are  also  traces 
of  masochism  (v.  infra). 


1  The  legend  is  especially  spread  throughout  the  Balkan  peninsula.  Among 
the  Greeks  it  has  its  origin  in  the  myth  of  the  lamke  and  marmolykes,  —  blood -sucking 
women.  Goethe  made  use  of  this  in  his  "Bride  of  Corinth."  The  verses  referring  to 
vampirism,  "suck  thy  heart's  blood,"  etc.,  can  be  thoroughly  understood  only  when 
compared  with  their  ancient  sources. 


88  PSYCHOPATHIA   SEXUALIS. 

Case  43.  Mrs.  H.,  of  H.,  aged  26,  comes  of  a  nervous  family,  in 
which  nervous  or  mental  diseases  are  said  not  to  have  occurred ;  but  the 
patient  herself  presents  signs  of  hysteria  and  neurasthenia.  Although 
eight  years  married,  and  the  mother  of  a  child,  Mrs.  H.  never  had  desire 
to  perform  coitus.  Very  strictly  educated  as  a  young  girl,  until  her  mar- 
riage she  remained  almost  innocent  of  any  knowledge  of  sexual  matters. 
She  has  menstruated  regularly  since  her  fifteenth  year.  There  does  not 
seem  to  be  any  essential  abnormality  of  the  genitals.  To  the  patient 
coitus  is  not  only  not  a  pleasure,  but  even  an  unpleasant  act ;  and  re- 
pugnance to  it  has  constantly  increased.  The  patient  cannot  understand 
how  any  one  can  call  such  an  act  the  greatest  delight  of  love,  which,  to 
her,  is  something  far  higher  and  unconnected  with  such  a  sensual  impulse. 
At  the  same  time,  it  should  be  mentioned  that  the  patient  really  loves  her 
husband.  In  kissing  him,  too,  she  experiences  a  decided  pleasure,  which 
she  cannot  exactly  describe.  But  she  cannot  conceive  how  the  genitals 
can  have  anything  to  do  with  love.  In  other  respects  Mrs.  H.  is  a 
decidedly  intelligent  woman,  of  feminine  character. 

Si  oscula  dat  conjugi,  magnum  voluptatem  percipit  in  mordendo 
eum.  Gratissimum  ei  esset  conjugem  mordere  eo  modo  ut  sanguis  fluat. 
Contenta  esset,  si  loco  coitus  morderetur  a  conjuge  ipsaeque  eum  mordere 
liceret.  Tamen  earn  poeniteret,  si  morsu  magnum  dolorem  faceret.  (Dr. 
Moll.) 

In  other  cases  of  sadism  which  history  and  literature  afford, 
we  are  compelled  to  think  of  a  reversal  of  the  feminine  sex- 
ual character, — a  partial  viraginity, — in  order  to  explain  the 
sadistic  acts. 

In  history  there  are  examples  of  famous  women  who, 
to  some  extent,  had  sadistic  instincts.  These  Messalinas  are 
particularly  characterized  by  their  thirst  for  power,  lust,  and 
cruelty.  Among  them  are  Valeria  Messalina  herself,  and 
Catherine  de  Medici,  the  instigator  of  the  Massacre  of  St. 
Bartholomew,  whose  greatest  pleasure  was  found  in  having  the 
ladies  of  her  court  whipped  before  her  eyes,  etc. 

The  gifted  Henry  von  Kleist,  who  was  undoubtedly  ment- 
ally abnormal,  gives  a  masterly  portrayal  of  complete  feminine 
sadism  in  his  "  Penthesilea."  In  scene  xxii,  Kleist  describes  his 
heroine  with  Achilles,  whom  she  had  been  pursuing  in  the  fire 
of  love,  betrayed  into  her  hands,  as,  overcome  with  lustful, 
murderous  fury,  she  tears  him  in  pieces  and  sets  her  dogs  on 
him:  "She  strikes,  tearing  the  armor  from  his  body;   they  set 


MASOCHISM  89 

their  teeth  in  his  white  breast, — she  and  her  dogs,  the  rivals, 
Oxus  and  Sphynx, — they  on  the  light  side,  she  on  the  left;  and 
as  I  approached  blood  dripped  from  her  hands  and  mouth." 
And  later,  when  Penthesilea  becomes  satiated :  "  Did  I  kiss  him 
to  death1?  No.  Did  I  not  kiss  him  %  Torn  in  pieces?  Then 
it  was  a  mistake;  kissing  rhymes  with  biting,  and  one  who 
loves  with  the  whole  heart  might  easily  mistake  the  one  for  the 
other."1 

2.  The  Association  of  Passively  Endured  Cruelty  and 
Violence,  ivith  Lust — Masochism? — Masochism  is  the  opposite  of 
sadism.  While  the  latter  is  the  desire  to  cause  pain  and  use  force, 
the  former  is  the  wish  to  suffer  pain  and  be  subjected  to  force. 

By  masochism  I  understand  a  peculiar  perversion  of  the 
psychical  vita  sexualis,  in  which  the  individual  affected,  in 
sexual  feeling  and  thought,  is  controlled  by  the  idea  of  being 
completely  and  unconditionally  subject  to  the  will  of  a  person 
of  the  opposite  sex ;  of  being  treated  by  this  person  as  by  a 
master, — humiliated  and  abused.  This  idea  is  colored  by  lustful 
feeling;  the  individual  affected  lives  in  fancies,  in  which  he  creates 
situations  of  this  kind,  and  often  attempts  to  realize  them.  By 
this  perversion  his  sexual  instinct  is  not  infrequently  made 
more  or  less  insensible  to  the  normal  stimulus  of  the  opposite 
sex, — incapable  of  a  normal  vita  sexualis, — psychically  impo- 
tent. But  this  psychical  impotence  does  not  in  any  way  depend 
upon  a  horror  sexus  alterius,  but  upon  the  fact  that  this  per- 
verse instinct  finds  an  adequate  satisfaction  differing  from  the 
normal, — in  woman,  to  be  sure,  but  not  in  coitus. 

But  cases  also  occur,  in  which,  with  the  perverse  impulse, 
there  is  also  sensibility,  in  a  measure,  to  normal  stimuli,  and 
intercourse  under  normal  conditions  takes  place.  In  other 
cases  the  impotence  is  not  purely  psychical,  but  physical,  i.e., 
spinal ;  for  this  perversion,  like  almost  all  other  perversions  of 
the  sexual  instinct,  is  developed  only  on  the  basis  of  a  psycho- 

1  In  the  latest  literature  we  find  the  matter  treated,  but  particularly  in  Sacher- 
Masoch's  novels,  which  are  hereafter  to  be  alluded  to,  and  in  Ernest  von  Wildenbruch's 
"  Brunhilde,"  Rachilde's  "  La  Marquise  de  Sadc,"  etc. 

2  So  named  from  the  writer,  Saclier-Masoch,  whose  romances  and  novels  have  as 
their  particular  object  the  description  of  this  perversion. 


90  PSYCHOPATHIA   SEXUALIS. 

pathic  and,  for  the  most  part,  hereditarily  predisposed  indi- 
viduality ;  and,  as  a  rule,  such  individuals  give  themselves  up 
to  excesses,  particularly  masturbation,  to  which  the  difficulty 
of  attaining  what  their  fancy  creates,  drives  them  again  and 
again. 

The  number  of  cases  of  undoubted  masochism  thus-  far 
observed  is  very  large.  Whether  masochism  occurs  associated 
with  normal  sexual  instincts,  or  exclusively  controls  the  indi- 
vidual ;  whether,  and  to  what  extent,  the  individual  subject  to 
this  perversion  strives  to  realize  his  peculiar  fancies  or  not; 
whether  he  has  thus  more  or  less  diminished  his  virility  or  not, — 
depends  upon  the  degree  of  intensity  of  the  perversion  in  the 
single  case,  and  upon  the"  strength  of  the  opposing  ethical  and 
aesthetic  motives,  as  well  as  the  relative  power  of  the  physical 
and  mental  organization,  of  the  affected  individual.  The  essen- 
tial thing,  from  the  psychopathic  point  of  view,  and  the  common 
element  in  all  these  cases,  is  the  fact  that  the  sexual  instinct  is 
directed  to  ideas  of  subjugation  and  abuse  by  the  opposite  sex. 

What  has  been  said  with  reference  to  the  impulsive  char- 
acter (indistinctness  of  motive)  of  the  resulting  acts,  and  with 
reference  to  the  original  (congenital)  nature  of  the  perversion 
in  sadism,  is  also  true  in  masochism. 

In  masochism  there  is  also  a  gradation  of  the  acts  from  the 
most  repulsive  and  monstrous  to  the  silliest,  in  accordance  with 
the  degree  of  intensity  of  the  perverse  instinct,  and  the  power  of 
the  remnants  of  moral  and  aesthetic  motives  that  oppose  it.  The 
ultimate  consequences  of  masochism,  however,  are  opposed  by 
the  instinct  of  self-preservation,  and,  therefore,  murder  and 
serious  injury,  which  may  be  committed  in  sadistic  excitement, 
have  here,  as  far  as  known,  no  passive  equivalent  in  reality;  but 
the  perverse  desires  of  masochistic  individuals  may,  in  imagina- 
tion, attain  these  extreme  consequences  (v.  infra,  Case  54). 

Moreover,  the  acts  to  which  masochists  give  themselves  up, 
are  performed  in  some  cases  in  connection  with  coitus,  i.e.,  as 
preparatory  measures ;  in  others,  as  substitutes  for  coitus  when 
that  is  impossible.  Here,  too,  this  depends  only  upon  the  con- 
dition of  sexual  power,  which  has  been  diminished  for  the  most 


MASOCHISM.  91 

part  physically  and  mentally  by  the  activity  of  the  sexual  ideas 
in  the  perverse  direction,  and  not  upon  the  nature  of  the  act 
itself. 

(a)  Tlie  Desire  for  Abuse  and  Humiliation  as  a  Means  of 
Sexual  Satisfaction. — The  following  detailed  autobiography  of 
a  masochist,  gives  an  exhaustive  description  of  a  typical  case  of 
this  remarkable  perversion  : — 

Case  44.  I  come  of  a  neuropathic  famity,  in  which,  with  all  kinds 
of  peculiarities  of  character  and  manner  of  life,  there  are  several  abnor- 
malities of  a  sexual  nature.  My  imagination  has  always  been  very  lively, 
and  was  very  early  directed  to  sexual  matters.  As  far  as  I  can  remember, 
I  was  much  given  to  onanism  long  before  puberty.  Even  at  that  time  my 
thoughts  were,  for  hours  at  a  time,  directed  to  intercourse  with  females. 
But  the  relations  in  which  I  placed  myself  with  the  opposite  sex  were 
entirely  peculiar.  I  fancied  that  I  was  a  prisoner  and  absolutely  in  a 
woman's  power,  and  that  this  woman  used  her  power  to  hurt  and  abuse 
me  in  every  way  possible.  In  this,  whipping  and  blows  played  an  im- 
portant part  in  my  fancy,  and  there  were  many  other  acts  and  situations 
which  all  expressed  the  condition  of  vassalage  and  subjection.  I  saw  my- 
self constantly  kneeling  before  my  ideal,  trod  upon,  loaded  with  chains, 
and  imprisoned.  Severe  punishments  of  all  kinds  were  inflicted  on  me,  to 
test  my  obedience  and  please  my  mistress.  The  more  severely  I  was 
humiliated  and  abused,  the  more  I  indulged  in  these  thoughts.  (At  the 
same  time  I  developed  a  great  preference  for  velvet  and  fur,  which  I 
liked  to  touch  and  smooth,  and  which  likewise  excited  me  sexually.) 

I  remember  well  that  when  a  child  I  received  many  actual  whip- 
pings at  the  hands  of  females.  They  never  caused  me  any  other  feeling 
than  pain  and  shame ;  never  have  I  thought  to  connect  such  realities 
with  my  fancies.  A  threat  to  punish  me  severely  and  correct  me  agitated 
me  painfully;  but  in  my  fancy  I  assumed  a  desire  on  the  part  of  my 
"  mistress  "  to  enjoy  my  suffering  and  humiliation,  which  entranced  me. 
Too,  I  have  never  brought  into  relation  with  my  fancies  the  acts  and 
orders  of  the  females  that  have  taken  care  of  me.  I  was  early  able  to 
discover  the  truth  about  the  relation  of  the  sexes;  but  this  knowledge 
made  no  impression  on  me.  The  idea  of  sensual  pleasure  remained  con- 
nected with  the  fancies  with  which  it  was  originally  associated.  I  also 
had  the  desire  to  touch  females,  to  embrace  and  kiss  them,  but  I  looked 
for  the  greatest  delight  onl}'  in  their  maltreatment,  and  in  situations  in 
which  they  would  cause  me  to  feel  their  power.  I  soon  came  to  realize 
that  I  differed  from  other  men,  and  preferred  to  be  alone  and  absorbed 
in  my  dreams.  In  my  boyhood,  real  girls  and  women  had  but  little  in- 
terest for  me ;  for  I  saw  no  possibility  of  having  them  act  in  the  way  I 
desired.     On  lonely  paths  in  the  forest  I  whipped  myself  with  branches 


92  PSTCHOPATHIA   SEXUALIS. 

that  had  fallen  from  the  trees,  and  allowed  my  imagination  to  play  in 
the  habitual  way.  I  reveled  in  the  sight  of  pictures  of  commanding 
women,  particularly  if,  like  queens,  they  wore  furs.  I  read  everything 
related  to  my  cherished  ideas.  "  Rousseau's  Confessions,"  which  then 
fell  into  my  hands,  was  a  great  discovery.  I  found  a  condition  described 
that  resembled  mine  in  essentials.  I  was  still  more  astonished  at  the 
similarity  of  my  ideas  to  those  I  read  of  in  the  writings  of  Sacher-Masoch. 
I  devoured  them  all  with  avidity,  though  the  blood-curdling  scenes  often 
far  outdid  my  imagination,  and  then  excited  my  aversion.  Later,  in 
order  to  supply  new  food  for  my  fancy,  I  began  to  write  descriptions  of 
erotic  scenes  to  my  taste,  and  to  make  drawings  of  situations  which,  up 
to  this  time,  I  had  painted  only  in  imagination.  In  this,  reality  was 
entirely  an  indifferent  matter  to  me.  In  the  presence  of  a  woman  I  was 
devoid  of  every  sensual  feeling ;  at  most,  at  the  sight  of  a  feminine  foot, 
there  would  come  a  fleeting  wish  to  be  trod  upon  by  it. 

This  indifference,  however,  was  only  in  relation  to  pure  sensuality. 
In  late  boyhood  and  early  youth  I  was  subject  to  an  enthusiastic  par- 
tiality for  young  girls  of  my  acquaintance,  with  all  the  extravagances 
common  to  this  youthful  enthusiasm.  But  it  never  occurred  to  me  to 
connect  the  world  of  my  sensual  thoughts  with  these  pure  ideals.  I 
never  had  to  overcome  such  a  thought ;  one  never  came  to  me.  This  is 
the  more  remarkable,  since  to  me  my  lustful  fancies  seemed  very  strange 
and  unattainable  in  reality,  but  in  no  wise  vile  or  obnoxious.  This,  too, 
was  a  kind  of  poetry  with  me ;  but  it  was  divided  into  two  worlds, — on 
the  one  hand  was  my  heart,  or,  rather,  my  aesthetically  excited  fancy ; 
on  the  other,  my  sensually  inflamed  imagination.  While  my  "  elevated  " 
feeling  always,  had  a  certain  young  girl  for  its  object,  at  other  times  I 
saw  myself  at  the  feet  of  a  mature  woman,  who  treated  me  as  previously 
described.  I  never  placed  any  lady  of  my  acquaintance  in  this  role. 
In  dreams  the  two  spheres  of  my  erotic  ideas  occurred  alternately, 
but  never  combined.  Only  the  images  of  the  sensual  sphere  induced 
pollutions. 

In  my  nineteenth  year  I  allowed  myself,  with  outward  reluctance, 
but  with  inward  desire,  to  be  taken  by  friends  to  visit  prostitutes.  But 
there  I  experienced  nothing  but  repugnance  and  aversion,  and  left  as 
soon  as  possible,  without  having  felt  the  faintest  trace  of  sensual  excite- 
ment. Later,  on  my  own  initiative,  I  repeated  the  attempt,  in  order  to 
convince  myself  as  to  whether  I  was  impotent  or  not ;  for  I  was  much  trou- 
bled by  my  unexpected  failure  in  the  first  instance.  The  result  was 
always  the  same, — I  felt  no  excitement  at  all,  and  had  not  the  slightest 
erection.  In  the  first  place,  it  was  not  possible  for  me  to  regard  a  real 
woman  as  an  object  of  sensual  gratification ;  and,  furthermore,  I  could 
not  renounce  the  conditions  and  situations  which  were  the  principal  things 
in  sexualibus  for  me,  and  about  which  nothing  could  induce  me  to  speak 
a  word.     Imissio  penis — the  act  to  be  undertaken  by  me — seemed  to  me 


MASOCHISM.  93 

absolutely  senseless  and  unclean.  Again,  in  the  second  place,  there  was 
also  my  repugnance  for  common  women,  and  fear  of  infection. 

In  the  meantime,  in  secret,  my  sexual  life  went  on  in  the  old  fashion. 
Whenever  my  old  fancies  came  to  mind,  violent  erection  occurred,  and  I 
provoked  ejaculations  almost  daily.  I  began  to  suffer  with  all  kinds  of 
nervous  troubles,  and  now  regarded  myself  as  impotent,  in  spite  of  power- 
ful erections  and  intense  desire  when  I  was  alone.  Nevertheless,  from 
time  to  time  I  continued  my  experiments  with  prostitutes.  In  time  I 
overcame  my  timidity,  and  in  part  my  aversion  to  contact  with  common 
women ;  but  I  remained  absolutely  cold. 

After  I  had,  with  advancing  years,  overcome  to  some  extent  my 
shyness  and  my  inclination  to  indulge  in  dreams,  in  my  sexual  thought 
there  was  an  approach  to  the  normal,  as  I  began  to  direct  my  interest  to 
real  persons.  I  was  even  successful  in  directing  sensual  thoughts  to 
women  of  my  acquaintance,  without  carrying  over  any  of  my  peculiar  ideas 
from  the  other  sphere.  Thus  I  had  some  affairs  with  respectable  girls. 
Embracing  and  kissing  occurred ;  desire  was  excited,  but  not  the  power, 
— at  least,  it  was  too  weak  to  allow  me  to  think  that  under  normal  circum- 
stances I  should  be  virile.  Of  course,  the  attention  I  gave  to  the  excita- 
tion of  my  sexual  power  was  not  calculated  to  favor  this.  Thus,  always 
greatly  ashamed,  I  broke  off  the  relations. 

With  this,  my  old  habit  continued.  I  was  still  a  great  onanist,  even 
though  with  lessened  power.  But  my  fancy  no  longer  satisfied  me  en- 
tirely. I  now  began  to  follow  both  respectable  women  and  others  on  the 
street ;  in  winter,  particularly  those  wearing  velvet  and  furs.  I  often 
followed  prostitutes  to  their  homes,  and  had  them  perform  manustupra- 
tion.  I  always  thought  I  should  find  more  real  pleasure  in  that  than  in 
my  fancies ;  but  it  was  always  less.  When  the  woman  took  off  her 
garments,  my  interest  followed  them.  The  empty  clothing  has  never 
attracted  me  very  strongly,  but  more  than  the  nude  female.  The  real 
object  of  my  interest  was  the  attired  woman.  In  this,  velvet  and  furs 
play  the  most  important  part;  but  also  all  other  articles  of  attire 
attracted  me,  and  particularly  the  form  as  brought  out  by  lacing  and 
padding.  I  had  scarcely  any  other  interest  in  the  nude  female  form  than 
an  aesthetic  one.  I  have  always  had  a  very  great  interest  in  the  shoes 
of  women,  particularly  in  slippers  with  high  heels,  which  is  always  con- 
nected with  the  thought  of  being  trod  upon,  or  of  submissively  kissing 
the  foot. 

At  last  I  overcame  the  last  vestige  of  my  shyness,  and  one  day,  to 
realize  my  dreams,  had  myself  whipped,  trod  upon,  etc.,  by  a  prostitute. 
The  result  was  a  great  disappointment.  What  was  done  to  me  I  felt  to 
be  rough,  repugnant,  and  silly.  The  blows  caused  me  nothing  but  pain  ; 
the  situation,  repugnance  and  shame.  Nevertheless,  I  induced  an  ejacu- 
lation mechanically,  with  which,  with  the  help  of  my  imagination,  I  trans- 
formed the  real  situation  into  that  for  which  I  longed.     This — the  really 


94  PSYCHOPATHIA   SEXUALIS. 

desired  situation — differed  from  the  actual  essentially  in  that  I  created 
in  imagination  a  woman  who  abused  me  with  the  same  pleasure  that  I 
experienced  in  her  maltreatment  of  me. 

All  my  sexual  fancies  were  erected  on  the  assumption  in  the  woman 
of  a  tyrannical,  cruel  disposition,  to  which  I  wished  to  be  subject.  The 
act  expressing  the  relation  was  a  secondary  matter  to  me.  After  the 
first  attempt  at  an  impossible  realization,  it  was  perfectly  clear  to  me 
toward  what  my  longing  was  directed.  To  be  sure,  in  my  lustful  dreams, 
I  had  often  passed  beyond  all  ideas  of  abuse,  and  conceived  a  command- 
ing woman,  with  an  imperious  mien,  a  word  of  command,  a  kiss  on  the 
foot,  etc. ;  but  now  I  fully  realized  what  it  was  that  attracted  me,  and 
that  flagellation  was  only  the  strongest  means  of  expressing  the  principle, 
and  in  itself  secondary. 

In  spite  of  this  disappointment,  after  the  first  step,  I  did  not 
abandon  my  efforts  to  realize  my  erotic  ideas.  I  was  confident  that, 
when  once  accustomed  to  the  new  reality,  my  fancy  would  find  food  in  it 
for  more  intense  activity.  For  my  purpose  I  sought  the  most  suitable 
women,  and  instructed  them  carefully  in  a  complicated  comedy.  In  this 
I  occasionally  found  that  the  way  had  been  prepared  for  me  by  prede- 
cessors of  like  disposition.  The  value  of  these  comedies,  for  the  effect 
of  my  fancy  on  my  sensuality,  remained  problematical.  What  these  acts 
and  scenes  did  for  me,  in  the  way  of  intensifying  the  subsidiary  circum- 
stances of  the  desired  situation,  caused  a  diminution  of  the  intensity  of 
the  principal  element,  which  my  unaided  fancy,  without  the  conscious- 
ness of  planned,  coarse  deception,  could  more  easily  bring  up  before 
me.  My  physical  sensations,  under  the  various  punishments,  were  change- 
able. The  more  perfect  the  self-deception,  the  more  perfectly  the  pain 
was  felt  as  pleasure. 

Or,  more  correctly,  the  punishment  was  then  conceived  as  a  sym- 
bolic act.  From  this  arose  the  illusion  of  the  desired  situation,  which 
was  then  accompanied  by  an  intense  psychical  feeling  of  pleasure.  The 
lustful  feeling  then  spread  out  over  the  whole  body  in  lustful  physical 
sensations,  and  thus  the  perception  of  the  painful  quality  of  the  punish- 
ment was  overcome.  The  process  in  the  moral  punishments — the  humili- 
ations to  which  I  subjected  myself — was  similar,  but  simpler ;  because  it 
was  confined  to  the  mental  sphere.  These  were  also  attended  with 
pleasurable  feeling  when  the  self-deception  succeeded.  It  was  seldom, 
however,  that  it  succeeded  well,  and  never  perfectly ;  there  always 
remained  a  disturbing  element  in  consciousness.  Therefore,  in  the 
intervals,  I  returned  to  solitaiy  onanism.  Moreover,  in  the  other  case, 
the  conclusion  of  the  act  was  usually  an  ejaculation  provoked  by  onanism!; 
often  an  ejaculation  without  the  aid  of  mechanical  means. 

Thus  I  went  on  for  many  years,  with  diminishing  power,  but  with 
slightly  diminished  desire,  and  with  the  power  of  my  peculiar  sexual 
idea  over  me  unchanged.     And  at  present  the  condition  of  my  vita  sex- 


MASOCHISM.  95 

ualis  is  the  same.  Coitus,  which  I  have  never  performed,  still  seems  to 
me  a  strange  and  unclean  act.  I  learned  about  it  from  descriptions  of 
sexual  dissipations.  My  own  sexual  ideas  seem  natural,  and  do  not  in 
the  least  offend  my  sensitive  taste.  Their  realization,  as  previously  men- 
tioned, for  various  reasons,  leaves  me  unsatisfied.  I  am  pleased  with 
pretty  girls  and  women  of  respectabilit}',  but  for  a  long  time  I  have 
ceased  to  approach  them.  I  have  never  attained,  not  even  partially,  a 
direct,  actual  realization  of  my  sexual  -fancy.  As  often  as  I  have  come 
into  close  relation  with  females,  I  have  felt  the  woman's  will  to  be 
beneath  mine,  never  vice  versa.  I  have  never  met  a  woman  manifesting 
a  desire  of  mastery  in  sexual  things.  Women  who  wish  to  rule  in  the 
household  and  exercise  petticoat  sovereignty  are  entirely  different  from 
my  erotic  ideals. 

My  whole  personality  presents  many  abnormalities  besides  the 
perversion  of  my  vita  sexualis ;  my  neuropathic  condition  is  expressed 
in  many  mental  and  physical  symptoms.  Besides,  I  think  I  recognize 
in  myself  an  original  abnormality  of  character  in  the  nature  of  a  re- 
semblance to  the  feminine  type ;  at  least,  I  regard  as  of  this  nature  my 
great  weakness  of  will,  and  my  great  lack  of  courage  in  the  presence  of 
men  and  animals,  which  is  in  contrast  with  my  coolness  in  the  face  of 
peril.     My  external  appearance  is  entirely  masculine. 

The  author  of  this  autobiography  also  made  me  the 
following  communication : — 

"  I  always  sought  to  find  out  whether  the  peculiar  ideas  that  ruled 
me  sexually  were  entertained  by  other  men.  Since  the  first  stories 
about  it  accidentally  came  to  my  ears,  I  have  sought  everywhere  to  learn 
of  it.  Since  it  is  really  a  process  of  inner  consciousness, 'it  is,  of  course, 
not  easy  to  identify  it,  and  it  cannot  always  be  done  with  certainty  ;  but 
I  assume  the  existence  of  masochism  where  I  find  perverse  sexual  acts 
that  cannot  be  explained  except  by  this  dominating  idea.  I  look  upon 
this  anomaly  as  wide-spread. 

"  I  have  heard  numerous  stories  about  it  from  prostitutes  here  in 
Berlin,  and  in  Vienna;  and  I  thus  learned  how  numerous  my  fellow-suf- 
ferers are.  I  am  always  careful  not  to  describe  my  own  experiences, 
or  ask  whether  they  know  of  such  ;  but  I  allow  these  persons  to  relate 
their  experiences  just  as  they  will. 

"  Simple  flagellation  is  so  common  tha't  almost  every  prostitute  is 
familiar  with  it ;  but  cases  of  real  masochism  are  very  frequent.  The 
men  subject  to  this  perversion  submit  themselves  to  the  most  refined 
cruelties.  In  this  they  always  act  the  same  farce  with  the  instructed 
prostitutes, — humiliating  subjection  of  the  man,  treading  upon  him,  com- 
mands, threats,  and  scoldings  that  have  been  committed  to  memory ; 
then  flagellation,  blows  on' various  portions  of  the  body,  and  all  kinds  of 


96  PSYCHOPATHIA   SEXUALIS. 

punisliment,  pricking  with  needles,  etc.  The  scenes  often  end  with  coitus, 
but  more  frequently  with  ejaculation  without  it.  Twice  prostitutes  have 
shown  me  heavy  iron  chains  with  handcuffs,  which  their  patrons  had 
made  for  them  to  put  on  them ;  and  the  dried  peas,  on  which  they 
kneeled  ;  the  seat  set  with  needles,  on  which  they  sat  at  command ;  and 
many  other  similar  things.  Often  the  perverted  man  wishes  the  woman 
to  tie  his  penis  so  tightly  as  to  cause  pain ;  to  prick  it  with  needles, 
make  cuts  in  it  with  a  knife,  or  beat  it  with  a  stick.  Even  the  act  of 
hanging  is  indulged  in,  it  being  cut  short  at  just  the  right  moment. 
Others  have  themselves  scratched  with  a  knife  or  dagger,  but  in  the  act 
the  woman  must  threaten  them  with  death.  In  all  these  things  the 
symbolism  of  subjection  is  the  most  important  factor.  The  woman  is 
usually  called  '  mistress';  the  man, '  slave.' 

"  A  man  of  high  social  standing,  dressed  as  a  servant,  sat  on  the 
box  of  a  carriage  and  drove  his  mistress  about.  Here  there  may  have 
been  a  conscious  imitation  of  the  '  Venus  in  Furs.'  It  seems  to  me  that 
the  writings  of  Sacher-Masoch  have  done  much  to  develop  this  perversion 
in  those  predisposed.  It  is  peculiar  that  the  inexplicable  enthusiasm  for 
furs  is  so  frequently  combined  with  this  perversion.  It,  as  well  as  that 
for  velvet,  has  been  peculiar  to  me  from  my  earliest  youth. 

"  All  these  comedies  with  prostitutes  are  for  masochists  only  trouble- 
some substitutes.  Whether  there  is  such  a  thing  as  a  realization  of 
masochistic  dreams  in  love  relations  or  not,  I  do  not  know.  If  it  occur, 
it  is  certainly  very  infrequent ;  for  this  taste  in  women  (sadism  in  women, 
as  described  by  Sacher-Masoch)  is  very  difficult  to  find ;  and,  too,  the 
expression  of  sexual  abnormalities  finds  greater  obstacles  in  the  modesty 
of  women,  etc.,  than  in  men.  I  myself  have  never  noticed  the  slightest 
indications  of  anything  of  this  kind,  and  have  never  been  able  to  attempt 
an  actual  realization  of  m}r  fancies.  Once  a  man  confidingly  told  me  of 
his  masochistic  perversion,  and  said  he  had  found  his  ideal." 

The  two  following  cases  are  similar  to  the  foregoing : — 

Case  45.  Mr.  Z.,  aged  29,  technicist,  came  for  consultation  because 
of  a  fear  of  tabes.  Father  was  nervous  and  died  tabetic.  Father's 
sister  was  insane.  Several  relatives  are  very  nervous  and  peculiar.  On 
closer  examination  the  patient  is  found  to  have  sexual,  spinal,  and  cerebral 
asthenia.  He  presents  no  S3'inptoms  of  tabes  dorsalis,  nor  does  he  give 
a  history  of  them.  Questions  concerning  abuse  of  the  sexual  organs 
bring  out  a  confession  of  masturbation  practiced  since  youth.  In  the 
course  of  the  examination  the  following  interesting  psycho-sexual  anoma- 
lies came  out:  At  the  age  of  five  the  vita  sexualis  began  with  the 
impulse  to  whip  himself,  as  well  as  with  the  desire  to  see  others  whipped. 
In  this  he  never  thought  of  individuals  as  of  one  sex  or  the  other.  Fante 
de  mieux  he  practiced  flagellation  on  himself  and,  in  time,  this  induced 


MASOCHISM.  97 

ejaculation.  Long  before  this  he  had  begun  to  satisfy  himself  with  mas- 
turbation, and  ahvaj-s  during  the  act  reveled  in  imaginary  scenes  of 
whipping.  After  growing  up  he  twice  visited  brothels  to  have  himself 
flogged  by  prostitutes.  For  this  purpose  he  chose  the  prettiest  girl  he 
could  find ;  but  he  was  disappointed,  and  did  not  even  have  an  erection, 
to  say  nothing  of  ejaculation.  He  recognized  that  the  flagellation  was 
subsidiary,  and  that  the  idea  of  subjection  to  the  woman's  will  was  the 
important  thing.  He  realized  this  on  the  second  trial.  When  he  had 
the  "  thought  of  subjection,"  he  was  perfectly  successful.  In  time,  by 
straining  his  imagination  with  masochistic  ideas,  he  performed  coitus 
without  flagellation  ;  but  he  found  little  satisfaction  in  it;  so  that  he  per- 
formed sexual  intercourse  in  a  masochistic  way.  He  found  pleasure  in 
masochistic  scenes,  in  the  sense  of  his  original  desire  for  flagellation, 
only  when  he  was  flagellated  ad  podicem,  or,  at  least,  only  when  he  called 
up  such  a  situation  in  imagination.  At  times  of  great  excitability  it  was 
even  sufficient  if  a  pretty  girl  told  stories  of  such  scenes.  He  would  thus 
have  an  orgasm,  and  usually  ejaculation. 

A  very  effectual  fetichistic  idea  was  early  associated  with  this.  He 
noticed  that  he  was  attracted  and  satisfied  only  by  women  wearing  high 
heels  and  short  jackets  ("  Hungarian  fashion  ").  He  does  not  know  how 
he  arrived  at  this  fetichistic  idea.  Boys'  legs  with  high  heels  also 
pleased  him,  but  this  charm  was  purely  aesthetic,  without  any  sensual 
coloring;  and  he  said  he  had  never  noticed  anything  homosexual  in  him- 
self. The  patient  referred  his  fetichism  to  his  partiality  for  calves  (legs). 
He  is  charmed  by  ladies'  calves  only  when  elegant  shoes  are  on  the 
feet.  Nude  legs — feminine  nudity  in  general — do  not  in  the  least  affect 
him  sexually.  A  subordinate  fetichistic  idea  for  the  patient  is  the  mas- 
culine ear.  It  is  a  lustful  pleasure  for  him  to  pet  the  ears  of  handsome 
men,  i.e.,  men  having  beautiful  ears.  With  men  this  pleasure  is  slight, 
but  with  women  it  gives  him  great  enjoyment. 

He  also  has  a  weakness  for  cats.  He  thinks  them  simply  beautiful ; 
and  their  movements  are  very  attractive  to  him.  The  sight  of  a  cat  can 
raise  him  from  a  feeling  of  the  deepest  depression.  Cats  seem  to  him 
sacred ;  he  sees  something  divine  in  them  !  He  does  not  know  the 
reason  for  this  idiosyncrasy. 

Of  late  he  has  also  frequently  had  sadistic  ideas  about  punishing 
boys.  In  these  imaginary  flagellations  both  men  and  women  play  a  part, 
but  particularly  the  latter ;  and  then  his  enjoyment  is  much  more  intense. 

The  patient  finds  that,  with  that  which  he  recognizes  and  feels 
as  masochism,  there  is  something  else  which  he  prefers  to  designate 
"  pageism." 

While  his  masochistic  fancies  and  acts  are  entirely  of  a  coarse, 
sensual  nature,  his  "  pageism  "  consists  of  the  idea  of  being  a  page  to  a 
beautiful  girl.  He  conceives  her  as  perfectly  chaste,  but  piquant ;  his  re- 
lation to  her,  that  of  a  slave,  but  perfectly  chaste, — a  purely  platonic 


98  PSYCHOPATHIA   SEXUALIS. 

submission.  This  reveling  in  the  idea  of  serving  such  a  "  beautiful  crea- 
ture "  as  a  page,  is  colored  by  a  pleasurable  feeling ;  but  this  is  in  no  way 
sexual.  He  experienced  in  it  an  exquisite  feeling  of  moral  satisfaction, 
in  contrast  with  the  sensually-colored  masochism ;  and,  therefore,  he 
could  but  regard  it  as  something  of  a  different  nature. 

At  first  sight  there  was  nothing  remarkable  in  the  patient's  appear- 
ance ;  but  his  pelvis  is  abnormally  broad,  the  ilia  are  flat,  and  the  pelvis, 
as  a  whole,  tilted  and  decidedly  feminine.  Eyes,  neuropathic.  He  also 
mentions  that  he  often  has  itching  and  lustful  irritation  at  the  anus,  and 
that  there  ("  erogenous  "  area),  ope  digiti,  he  can  satisfy  himself. 

The  patient  is  troubled  about  his  future.  Help  would  be  possible 
for  him  if  he  could  but  excite  in  himself  an  interest  in  women,  but  his 
will  and  imagination  were  too  weak  for  that. 

What  the  patient  designates  as  "pageism"  does  not  differ 
in  any  way  from  masochism,  as  may  be  seen  when  it  is  com- 
pared with  the  following  cases  of  symbolic  masochism,  and 
others ;  and,  further,  upon  the  consideration  that  in  this  per- 
version coitus  is  avoided  as  an  inadequate  act ;  and  from  the 
fact  that  in  such  cases  there  is  often  a  fantastic  exaltation  of 
the  perverse  ideal : — 

Case  46.  X,  writer,  aged  28,  predisposed.  Sexually  hyperaesthetic 
from  childhood.  At  the  age  of  six  he  had  dreams  of  being  whipped 
ad  nates  by  a  woman.  After  them  he  would  awake  in  intense  lustful 
excitement ;  and  thus  he  came  to  practice  onanism.  When  eight  years 
old  he  once  asked  the  cook  to  whip  him.  From  his  tenth  year,  neu- 
rasthenia. Until  his  twenty-fifth  j^ear  he  had  dreams  of  flagellation,  or 
similar  waking  fancies,  and  indulged  in  onanism.  Three  years  ago  he 
had  an  impulse  to  have  himself  whipped  by  a  puella.  The  patient  was 
undeceived,  for  neither  erection  nor  ejaculation  occurred.  At  twenty- 
seven,  another  effort,  with  the  thought  to  enforce  erection  and  ejacula- 
tion. This  was  finally  made  possible  by  the  following  artifice:  While 
coitus  was  attempted,  the  puella  had  to  tell  him  how  she  had  mercilessly 
flogged  other  impotent  men,  and  threaten  him  with  the  same.  Besides 
this,  it  was  necessary  for  him  to  fancy  that  he  was  bound,  entirely 
in  the  woman's  power,  helpless,  and  most  painfully  beaten  by  her.  Oc- 
casionally, in  order  to  become  potent,  it  was  necessary  to  have  himself 
actually  bound.  Thus  coitus  was  possible.  Pollutions  were  accompa- 
nied by  lustful  feeling  only  when  he  (infrequently)  dreamed  that  he  was 
abused,  or  that  he  looked  on  while  a  puella  whipped  others.  He  never 
had  an  intense,  lustful  pleasure  in  coitus.  The  only  things  in  women  that 
interest  him  are  the  hands.  Powerful  women  with  big  fists  are  his 
preference.    At  the  same  time,  his  desire  for  flagellation  is  only  ideal ;  for 


MASOCHISM.  99 

with  his  great  cutaneous  sensitiveness,  at  the  most,  a  few  strokes  are 
sufficient.  Blows  from  men  were  repugnant  to  him.  He  wishes  to 
marry.  From  the  impossibility  of  asking  a  decent  woman  to  perform 
flagellation,  and  the  doubt  about  being  potent  with  such  a  woman, 
spring  his  embarrassment  and  desire  to  recover. 

In  the  foregoing  three  cases,  for  the  most  part,  passive 
flagellation  serves  the  individual  subject  to  this  perversion  of 
masochism  as  an  expression  of  the  desired  situation  of  subjection 
to  the  woman.  The  same  means  is  needed  by  a  large  number 
of  masochists.  But  passive  flagellation  is  a  process  which,  as  is 
known,  has  a  tendency  to  induce  erection  reflexly  by  irritation 
of  the  nerves  of  the  nates.1  This  effect  of  flagellation  is  used 
by  weakened  debauchees  to  help  their  diminished  power ;  and 
this  perversity — not  perversion — is  very  common.  It  is,  there- 
fore, necessary  to  ascertain  in  what  relation  the  passive  flagella- 
tion of  the  masochists  stands  to  these  dissipated  individuals  who 
are  not  psychically  perverse,  but  physically  weakened. 

It  is  not  difficult  to  show  that  masochism  is  something 
essentially  different  from  flagellation,  and  more  comprehensive ; 
that  flagellation  is  rather  a  by-play, — one  of  the  many  means 
used  for  the  purpose  of  masochistic  gratification  in  the  sense  of 
subjection  to  the  woman.  For  the  masochist  the  principal 
thing  is  subjection  to  the  woman ;  the  punishment  is  only  the 
expression  of  this  relation, — the  most  intense  effect  of  it  he 
can  bring  upon  himself.  For  him  the  act  has  only  a  symbolic 
value,  and  is  a  means  to  the  end  of  mental  satisfaction  of  his 
peculiar  desires.  The  essential  thing  is  the  desire  for  ill-treat- 
ment, as  a  sign  of  this  subjection.  Besides  flagellation,  and 
often  without  it,  there  are  many  other  things  which  serve  to 
express  this  subjection ;  as  is  shown  by  the  following  series  of 
cases.  This  fact  establishes  a  presumption  of  the  existence  of 
an  original  anomaly  of  sexual  feeling, — a  paresthesia  sexualis. 
On  the  other  hand,  the  individual  that  is  weakened  and  not  a 
subject  of  masochism,  and  who  has  himself  flagellated,  desires 
only  a  mechanical  irritation  of  his  spinal  centre. 

Whether,  in  a  given  case,  it  is  simple  (reflex)  flagellation 

1  Comp.,  supra,  Introduction,  p.  28. 


100  PSYCHOPATHIA   SEXUALIS. 

or  masochism,  is  made  clear  by  the  individual's  statements,  and 
often  by  the  secondary  circumstances.  The  determination  de- 
pends upon  the  following  facts  : — 

In  the  first  place,  the  impulse  to  passive  flagellation  exists 
ab  origine  in  the  masochist.  The  desire  is  felt  before  there 
has  been  any  experience  of  the  reflex  effect,  often  first  in 
dreams ;  as,  for  example,  in  Case  48.  Secondly,  with  the  maso- 
chist, as  a  rule,  the  flagellation  is  only  one  of  many  and  various 
punishments  which  come  into  his  mind  as  fancies  and  are  often 
realized.  In  these  other  punishments,  and  the  frequent  acts 
expressing  purely  symbolic  humiliations,  which  occur  by  the 
side  of  flagellation,  there  can,  of  course,  be  no  thought  of  a 
reflex  physical  irritative  effect.  Thirdly,  it  is  significant  that, 
in  the  masochist,  when  the  desired  flagellation  is  carried  out,  it 
need  have  no  aphrodisiac  effect  at  all.  Very  often,  indeed, 
there  is  a  more  or  less  perfect  disappointment ;  in  fact,  always, 
if  the  masochist  is  not  successful  in  his  desire  to  create,  by 
means  of  the  pre-arranged  programme,  the  illusion  of  the  desired 
situation  (to  be  in  the  woman's  power),  so  that  the  woman 
ordered  to  carry  out  the  act  seems  to  be  nothing  more  than  the 
executive  agent  of  his  own  will.  If  one  cannot  tickle  one's 
self,  no  more  can  one  feel  one's  self  subject  to  a  woman 
directed  by  one's  own  will.  In  reference  to  this  important  point, 
compare  the  three  foregoing  cases  and  Case  50. 

Between  masochism  and  simple  (reflex)  flagellation,  there 
is  a  relation  somewhat  analogous  to  that  existing  between  con- 
trary sexual  instinct  and  acquired  pederasty.  It  does  not  lessen 
the  value  of  this  opinion  that,  in  the  masochist,  the  flagellation 
may  also  have  the  known  reflex  effect;  or  that  a  whipping 
received  in  childhood  may  have  aroused  lust  for  the  first  time, 
and  thus  simultaneously  excited  the  latent  masochistically-consti- 
tuted vita  sexualis.  In  this  event,  the  case  must  be  characterized 
by  the  conditions  mentioned  above,  under  the  heads  of  "secondly  " 
and  "  thirdly"  in  order  to  be  masochistic.  If  the  details  of  the 
origin  of  the  case  are  not  known,  other  circumstances,  such  as 
those  mentioned  above  under  "secondly"  would  make  it  clearly 
masochistic.     This  is  illustrated  in  the  two  following  cases: — 


MASOCHISM.  101 

Case  47.  A  patient  of  Tarnowsky's  had  a  person  in  his  confidence 
rent  a  house  during  his  "attacks,  and  instruct  its  personnel  (three  pros- 
titutes) in  what  was  to  be  done  with  him.  He  would  come  there,  and 
was  there  undressed,  man ustuprated,  and  flagellated,  as  ordered.  He  pre- 
tended to  offer  resistance,  and  begged  for  mercy  ;  then,  as  ordered,  he 
was  allowed  to  eat  and  sleep.  But  in  spite  of  protest  he  was  kept 
there,  and  beaten  if  he  did  not  submit.  Tims  the  affair  would  go  on 
for  some  days.  When  the  attack  was  over,  he  was  dismissed  ;  and  he  re- 
turned to  his  wife  and  children,  who  had  no  suspicion  of  his  disease. 
The  attacks  occurred  once  or  twice  a  year.     (Tarnowsky,  op.  cit.) 

Case  48.  X.,  aged  34,  greatly  predisposed,  suffers  with  contrary 
sexual  instinct.  For  various  reasons  he  had  no  opportune  to  satisfy 
himself  with  men,  in  spite  of  great  sexual  desire.  Occasionally  he 
dreamed  that  a  woman  whipped  him,  and  then  had  a  pollution. 

Through  this  dream  he  came  to  have  prostitutes  beat  him  as  a  sub- 
stitute for  love  with  men.  Occasionally  he  would  obtain  a  prostitute, 
undress  himself  completely  (while  she  was  not  to  take  off  a  thing),  and 
have  her  tread  upon  him,  whip,  and  beat  hrm.  Qua  re  summa  libidine 
affectus  pedein  feminse  lambit  quod  solum  cum  libidinosum  facere  potest: 
turn  ejaculationem  assequitur.  Then  disgust  at  the  morally-debasing 
situation  occurred,  and  he  retired  as  quickly  as  possible. 

Cases  occur,  however,  in  which  passive  flagellation  alone 
constitutes  the  entire  content  of  the  masochistic  fancies,  with- 
out other  ideas  of  humiliation,  etc.,  and  without  any  clear  con- 
sciousness of  the  real  nature  of  this  expression  of  submission. 
Such  cases  are  difficult  to  differentiate  from  those  of  simple 
reflex  flagellation.  A  knowledge  of  the  primary  origin  of  the 
desire,  before  any  experience  of  reflex  stimuli  (v.  supra,  under 
'""first"),  is  the  only  thing  that,  makes  the  differential  diagnosis 
certain ;  taken  with  the  circumstance  that  genuine  masochists 
are  perverse  in  their  youth,  and  that  the  realization  of  their 
desires  usually  comes  late,  or  undeceives  them  (v.  supra,  under 
"thirdly");  for  the  whole  thing,  for  the  most  part,  belongs  to 
the  sphere  of  the  imagination. 

The  following  case  is  of  this  nature : — 

Case  49.  Autobiography. — In  January,  1891 , 1  received  the  following 
letter  from  a  gentleman  in  Hungary  :  "  In  depression  and  despair  of  a 
life  that  shuts  me  out  from  all  that  makes  human  happiness,  I  come  to 
you  with  the  last  gleam  of  hope  of  rescue  from  a  condition  which,  if  it 
continue,  can  end  only  tragically. 


102  PSYCHOPATHIA   SEXUALIS. 

"I  am  thirty /years  old,  and  come  of  a  mother  who  suffered  with 
periodical  insanity.  As  early  as  my  fourteenth"  year  abnormal  sexual 
tendencies  were  noticeable  in  me.  It  always  gave  me  a  certain  lustful 
pleasure  to  be  whipped  by  boys  of  my  own  age,  particularly  when  I  was 
taken  over  the  knee  and  spanked.  It  particularly  delighted  me  when 
this  was  done  by  handsome  young  persons  or  boys  having  well  formed 
legs  and  closely-fitting  trousers.  By  means  of  such  ideas  I  also  came  to 
masturbate;  and  I  practiced  onanism  quite  frequently, — almost  daily, 
and,  in  fact,  in  absolute  ignorance  of  the  terrible  results  of  the  vice. 
Thus  it  continued  until  my  eighteenth  year,  when,  thus  far  absolutely 
unsuspecting,  I  was  made  aware  of  the  vicious  results  of  the  practice.  ' 

"  From  this  time  began  the  terrible  struggle  with  the  desire  to  give 
it  up,  which  I  only  too  often  abandoned.  The  fancies  mentioned  did  not 
leave  me ;  I  longed  to  be  whipped  by  handsome  young  persons  aged  from 
twenty  to  twenty-two  years,  wearing  tight  trousers.  My  fancy  was  filled 
especially  with  young  soldiers  and  hussars.  At  times  I  was  able  to  re- 
press my  imagination  and  avoid  onanism  ;  but  I  then  had  pollutions  with 
dreams  of  the  same  nature. 

"  After  my  twentieth  year,  to  my  astonishment,  the  sexual  in- 
clination toward  women,  which  I  had  noticed  in  comrades  of  nry  own 
age,  and  the  occurrence  of  which  I  expected  in  nvyself,  did  not  appear. 
I  was  cold  toward  women,  and  embarrassed  in  their  pi'esence.  At  the 
same  time,  feminine  nudity  was  not  unpleasant ;  on  the  contrary,  there 
was  something  attractive  about  it,  but  my  sensuality  was  not  excited. 

"  I  twice  attempted  coitus  ;  I  was  not  troubled  about  being  in  bed 
with  the  girl,  but  rather  kissed  and  embraced  her  with  pleasure,  and  even 
had  traces  of  erection,  but  that  was  all.  Since  then  I  have  had  no  hope, 
and  occasionally  returned  to  onanism,  which  I  had  avoided  for  some 
months  previously.  Nevertheless,  I  cultivated  social  intercourse  with 
ladies,  and  particularly  young  girls ;  and  I  was  esteemed  in  society,  and 
liked  for  my  graceful  dancing.  I  was  always  hoping  that  in  this  way 
my  unhappy  tendency  would  be  overcome  successfully,  but  in  vain  ;  it 
grew  constantly  stronger.  Thus  I  have  lived  hours  of  wretchedness ; 
and  the  ghost  of  suicide  has  passed  before  me.  I  once  confided  in  a 
physician  in  Pesth,  but  he  had  only  the  usual  remedies  for  persons  suf- 
fering with  sexual  weakness, — cold  baths,  quieting  medicines,  intercourse 
with  women,  etc. 

"  I  tried  everything  in  vain,  until  by  accident  a  book  on  contrary 
sexual  instinct  fell  into  my  hands,  and  gave  me  the  last  ray  of  hope.  I 
have  a  respected  position  as  a  merchant,  and  appreciate  thoroughly  the 
joys  of  family  life ;  and  I  have  an  opportunit}'  to  marry,  under  the  most 
favorable  circumstances,  a  young  girl  whom  I  love,  and  who  loves  me. 
But  I  feel  the  cruel  impossibility  of  this  step.  I  suffer  terribty  in  think- 
ing about  these  repulsive  abnormalities.  My  only  hope  lies  in  a  cure  by 
means  of  hypnosis.    May  it  not  be  in  vain !  " 


MASOCHISM.  103 

Pity  and  a  scientific  interest  induced  me  to  invite  the  writer  of  the 
preceding  lines  to  come  to  see  me.  Early  in  February  Mr.  D.  came. 
He  was  distinguished,  pleasing,  and  masculine  in  appearance.  Exam- 
ination of  the  case  showed  it  to  be  one  of  masochism.  He  distinctly 
remembered  that,  when  he  once  saw  fellow-pupils  whipped  by  the  teacher, 
it  gave  him  a  feeling  of  lustful  pleasure.  He  cannot  remember  that  he 
was  ever  whipped  by  a  teacher.  His  masochism  had  been  an  absolutely 
primary  manifestation,  and  incomprehensible  to  him.  Only  gradually 
and  faute  de  mieux  had  he  come  to  practice  onanism,  during  which  ideas 
of  flagellation,  in  which  he  phiyed  the  passive  role,  filled  his  mind.  He 
had  never  had  desire  to  be  whipped  by  the  teacher ;  he  always  wished  to 
be  flogged  b}'  fellow-pupils  and  well-grown  young  persons.  Since  ma- 
turity he  had  never  been  able  to  induce  himself  to  satisfy  his  masochistic 
inclinations. 

In  intercourse  with  puellis  he  had  repeatedly  had  the  thought  to 
have  himself  whipped  by  them  ;  but  since  this  was  not  accompanied  by 
sensual  feeling,  it  was  not  carried  out.  The  patient  declares  that  his  in- 
clinations toward  persons  of  his  own  sex  are  purely  masochistic.  In 
other  respects  he  finds  nothing  interesting  in  men.  Until  his  eighteenth 
•year  the  patient  had  also  sadistic  tendencies.  He  was  enthusiastic  about 
the  position  of  the  pedagogue  and  wanted  to  be  a  teacher  in  order  to  be 
able  to  flog  boys.  This  ideal  sadism  later  disappeared  entirely.  The 
patient  complains  that  he  feels  alone  in  the  world,  like  a  pariah,  and  that 
lie  is  different  from  other  men.  But  his  libido  toward  women  had  much 
diminished,  possibly  as  a  result  of  his  masturbation.  He  had  no  erec- 
tion at  the  sight  of  feminine  charms,  but  the  sight  of  a  riding-whip  or  a 
cane  excited  him  powerfully  sexually.  When  he  attempted  coitus,  no 
masochistic  ideas  occurred.  Such  ideas  arose,  however,  whenever  he 
saw  attractive  young  men.  He  believed  that  if  he  were  freed  from  his 
ideas  of  flagellation,  he  would  be  helped ;  for  his  sensuality  would  then 
direct  itself  in  a  normal  path. 

The  patient  has  neuropathic  eyes,  but  is  free  from  all  degenerative 
signs.  In  the  direction  of  hereditary  taint,  it  is  noteworthy  that  his 
maternal  grandfather  was  peculiar,  and  shot  himself  while  in  a  ps}'cho- 
pathic  condition.  The  patient  feels  well,  save  for  slight  neurasthenic 
troubles.  Patellar  reflex  increased.  The  genitals  are  perfectly  normal. 
His  dreams  with  pollutions  are  exclusively  about  flagellation  by  young 
persons,  particularly  soldiers  with  tight  trousers. 

The  principles  of  treatment  laid  down  were  :  1.  Removal  of  the 
sj-mptoms  of  neurasthenia.  2.  Suggestive  treatment  looking  to  (a) 
avoidance  of  onanism  ;  (6)  indifference  toward  his  own  sex  and  the 
disappearance  of  thoughts  of  flagellation,  both  while  awake  and  asleep; 
(c)  libido  exclusively  toward  persons  of  the  opposite  sex,  the  occurrence 
of  erections  at  sight  of  beautiful  women,  complete  power  with  women, 
and  dreams  of  women  exclusively.     At  the  first  sitting,  by  means  of 


104  PSTCHOPATHIA    SEXUALIS. 

Bernheim's  method,  the  patient  passed  quickly  into  a  state  of  deep 
lethargy.  At  the  second  sitting  (February  5)  a  cataleptic  condition 
of  the  muscles  was  induced.  Sittings  almost  daily.  It  was  seen  that 
stroking  the  brow  induced  deeper  l^-pnosis  with  catalepsy,  which,  how- 
ever, did  not  go  beyond  deep  letharg}^.  Suggestion  was  begun  in  the 
third  sitting. 

February  10.  The  patient  says  that  he  has  no  longer  any  interest 
in  men,  but  a  growing  interest  in  women.  He  begins  to  dream  of 
women. 

February  13.  He  feels  himself  free  from  masochism  during  the 
da}',  and  canes  and  whipping  do  not  interest  him  any  more.  At  night  he 
still  has  "  weak  "  dreams  of  flagellation  concerning  men,  but  without 
lustful  feeling  or  pollution.  A  short  time  ago  he  had  had  a  dream  that 
was  entirely  strange,  and  without  erotic  coloring,  to  the  effect  that  he 
whipped  himself. 

February  19.  The  patient  attempted  coitus  with  a  puella  pleasing 
to  him.  Erection  was  incomplete,  and  ejaculation  did  not  occur;  so  he 
gave  up  the  attempt.  The  patient  finds  that  his  libido  toward  women  is 
still  very  slight.  He  was  not  discouraged  by  his  failure,  and  expected 
ultimate  success ;  for  he  felt  free  from  his  abnormal  tendencies,  and  like 
another  man.  On  February  20,  unfortunately,  the  patient  had  to  dis- 
continue treatment,  being  called  home  by  duties  there. 

The  fact  that  traces  of  sadism  (v.  infra)  were  simultaneously 
present,  lends  certainty  to  the  diagnosis  of  this  rudimentary  case 
as  one  of  masochism.  The  purely  psychical  character  of  this  lat- 
ter perversion  is  unquestionable.  At  the  same  time,  the  case  is 
combined  with  incompletely  developed  contrary  sexual  instinct, 
an  association  not  infrequent  in  masochists  and  sadists.     . 

In  contrast  with  this  case  of  rudimentary  masochism,  in 
which  there  is  some  difficulty  of  diagnosis,  follows  a  typical 
case  of  masochism,  in  which  the  whole  circle  of  ideas  peculiar 
to  this  perversion  appears  completely  developed.  This  case,  in 
which  there  is  a  detailed  personal  description  of  the  whole  psy- 
chical state,  is  different  from  Case  44  only  in  that  here  there  is  no 
thought  of  a  realization  of  the  perverse  fancies ;  and  that,  not- 
withstanding the  perversion  of  the  vita  sexualis,  normal  stimuli 
are  so  far  effectual  that  sexual  intercourse  is  possible  under 
normal  conditions. 

Case  50.  I  am  thirty-five  years  old,  mentally  and  physically  normal. 
Among  all  my  relatives,  in  the  direct  as  well  as  in  the  lateral  line,  I  know 


MASOCHISM.  105 

of  no  case  of  mental  disease.  My  father,  who,  at  my  birth,  was  thirty 
years  old,  as  far  as  I  know,  had  a  preference  for  voluptuous,  large  women. 

Even  in  my  early  childhood  I  loved  to  revel  in  ideas  about  the 
absolute  mastery  of  one  man  over  others.  The  thought  of  slavery  had 
something  exciting  in  it  for  me,  and  alike  whether  from  the  stand-point 
of  master  or  servant.  That  one  man  could  possess,  sell,  or  whip  another, 
caused  me  intense  excitement;  and  in  reading  "  Uncle  Tom's  Cabin" 
(which  I  read  at  about  the  beginning  of  puberty),  I  had  erections.  Par- 
ticularly exciting  for  me  was  the  thought  of  a  man's  being  hitched  up 
before  a  wagon  in  which  another  man  sat  with  a  whip,  driving  and  whip- 
ping him.  Until  my  twentieth  year  these  ideas  were  purely  objective  and 
sexless, — i.e.,  the  one  in  subjugation  in  my  fancy  was  another  (not 
myself),  and  the  master  was  not  necessarily  a  woman.  These  ideas  were, 
therefore,  without  effect  on  my  sexual  instinct, — i.e.,  on  the  way  in  which 
it  was  expressed.  Though  these  ideas  caused  erections,  yet  I  have  never 
masturbated  in  my  life ;  and  from  my  nineteenth  year  I  had  coitus  with- 
out the  help  of  these  ideas  and  without  any  relation  to  them.  I  alwa3Ts 
had  a  great  preference  for  elderly,  voluptuous,  large  women,  though  I 
did  not  scorn  younger  ones. 

After  my  twenty -first  jTear  my  ideas  became  objective,  and  it 
became  an  essential  thing  that  the  "  mistress  "  should  be  a  woman  over 
forty  years  old,  tall,  and  powerful.  From  this  time  I  was  always,  in  my 
fancies,  the  subject ;  the  "  mistress  "  was  a  rough  woman,  who  made  use 
of  me  in  every  way,  also  sexually ;  who  harnessed  me  before  a  carriage, 
and  made  me  take  her  for  a  drive;  whom  I  must  follow  like  a  dog;  at 
whose  feet  I  must  lie  naked,  and  be  punished — i.e.,  whipped — by  heiv. 
This  was  the  constant  element  in  my  ideas,  around  which  all  others  were 
grouped.  In  these  fancies  I  always  found  endless  pleasure,  which  caused 
erection,  but  never  ejaculation.  As  a  result  of  the  induced  sexual  ex- 
citement, I  would  immediately  seek  a  woman,  preferably  one  correspond- 
ing exteriorly  with  my  ideal,  and  have  coitus  with  her  without  any  actual 
imitation  of  my  fancies,  and  sometimes  also  without  any  thought  of  them 
during  the  act.  At  the  same  time,  I  also  had  inclination  toward  women 
of  a  different  kind,  and  had  coitus  with  them  without  being  impelled  to 
it  by  my  fancy. 

Notwithstanding  all  this,  my  life  was  not  exceedingly  abnormal 
sexually  ;  yet  these  ideas  were  certain  to  occur  periodically,  and  they  have 
remained  essentially  unchanged.  With  growing  sexual  desire,  the  inter- 
vals constantly  grew  shorter.  At  the  present  time  the  ideas  come  every 
two  or  three  weeks.  If  I  have  had  coitus,  the  occurrence  of  the  fancies 
is  perhaps  postponed.  I  have  never  attempted  to  realize  my  very  definite 
and  characteristic  ideas, — i.e.,  to  connect  them  with  the  objective  world, 
— but  I  have  contented  myself  with  reveling  in  the  thoughts  ;  because  I 
was  convinced  that  my  ideal  would  not  allow  even  an  approach  to  realiza- 
tion.    The  thought  of  a  comedy  with  paid  prostitutes  always  seemed  to 


106  PSYCHOPATHIA   SEXtJALlS. 

me  silly  and  purposeless  ;  foi*  a  person  hired  by  me  could  never  take  the 
place  in  my  imagination  of  a  "  cruel  mistress."  I  doubt  whether  there 
are  sadistically  constituted  women  like  Sacher-Masoch's  heroines.  But, 
if  there  were  such  women,  and  I  had  the  fortune  (!)  to  find  one,  still,  in  a 
world  of  reality,  intercourse  with  her  would  always  seem  only  like  a 
farce  to  me.  Indeed,  I  can  say  that,  were  I  to  become  the  slave  of  a 
Messalina,  I  believe  that,  owing  to  the  other  necessary  renunciations, 
ray  desired  manner  of  life  would  soon  pall  on  me,  and  in  my  lucid 
intervals  I  should  try  to  obtain  my  freedom  at  all  hazards. 

Yet  I  have  found  a  way  in  which  to  induce,  in  a  certain  sense,  a 
realization.  After  my  sexual  desire  has  been  intensely  excited  by  revel- 
ing in  my  fancy,  I  go  to  a  prostitute  and  there  call  up  before  my  mind's 
eye,  with  great  intensity,  some  scene  of  the  kind  mentioned,  in  which  I 
play  the  principal  role.  After  thinking  of  such  a  situation  for  about 
half  an  hour,  with  a  constantly  resulting  erection,  I  perform  coitus  with 
increased  lustful  pleasure  and  strong  ejaculation.  After  the  latter,  the 
vision  fades  away.  Ashamed,  I  depart  as  quickly  as  possible,  and  try 
not  to  think  of  the  affair.  Then,  for  about  two  weeks,  I  have  no  more 
such  ideas  ;  indeed,  after  a  particularly  satisfactory  coitus,  it  may  happen 
that,  until  the  next  attack,  I  have  no  sympathy  whatever  with  masochistic 
ideas.  But  the  next  attack  is  sure  to  come  sooner  or  later.  I  must, 
however,  state  that  I  also  have  coitus  without  being  prepared  by  such 
ideas,  especially,  too,  with  women  that  are  acquainted  with  me  and  my 
position,  and  in  whose  presence  I  abhor  such  fancies.  Under  the  latter 
circumstances,  however,  I  am  not  always  potent,  while,  with  masochistic 
ideas,  my  virility  is  perfect.  It  does  not  seem  superfluous  to  add  that 
otherwise,  in  my  thought  and  feeling,  I  am  very  aesthetic,  and  despise 
anything  like  maltreatment  of  a  human  being.  Finally,  I  will  not  leave 
unmentioned  the  fact  that  the  form  of  address  is  of  importance.  In  my 
fancies  it  is  essential  that  the  "  mistress  "  address  me  in  the  second  per- 
son (Du),  while  I  must  address  her  in  the  third  (Sie).  This  circum- 
stance of  being  thus  familiarly  addressed  (Du)  by  a  person  so  inclined, 
as  the  expression  of  absolute  mastery,  has,  from  my  youth,  given  me 
lustful  pleasure,  and  does  to-day. 

I  had  the  fortune  to  find  a  wife  who  is  in  everything,  but  especially 
sexually,  attractive  to  me ;  though,  as  I  scarcely  need  say,  she  in  no  way 
resembles  my  masochistic  ideal.  She  is  gentle,  but  proud ;  for  without 
the  latter  characteristic  I  cannot  conceive  such  a  thing  as  sexual  charm. 
The  first  few  months  of  married  life  were  normal  sexually ;  the  maso- 
chistic attacks  did  not  occur,  and  I  had  almost  lost  all  thought  of  maso- 
chism. Then  came  the  first  confinement  and  the  necessary  abstinence. 
Punctually,  then,  with  the  occurrence  of  libido,  came  the  masochistic 
fancies  again,  which,  in  spite  of  my  great  love  for  nry  wife,  necessitated 
coitus  with  another,  with  the  accompaniment  of  masochistic  ideas.  It 
is  here  worthy  of  note  that  coitus  maritalis,  which  was  later  resumed, 


MASOCHISM.  107 

did  not  prove  sufficient  to  banish  the  masochistic  ideas,  as  masochistic 
coitus  always*  does.  As  for  the  essential  element  in  masochism,  I  am 
of  the  opinion  that  the  ideas, — i.e.,  the  mental  element, — are  the  end 
and  aim. 

If  the  realization  of  the  masochistic  ideas  (i.e.,  passive  flagellation, 
etc.)  be  the  desired  end,  then  it  is  in  opposition  with  the  fact  that  the 
majority  of  masochists  never  attempt  realization  ;  or,  when  this  is 
attempted,  great  disappointment  occurs,  or  at  least  the  desired  satisfac- 
tion is  not  obtained. 

Thus  the  reveling  in  imagination  is  the  principal  thing ;  and,  in  fact, 
this  gives  an  unspeakable  delight  that  takes  its  subject  beyond  external 
things,  bej'ond  all  troubles  and  cares. 

It  is  an  astonishing  fact  that  there  is  an  author,  who,  instead  of 
keeping  them  to  himself,  as  others  do,  discloses  his  imaginary  ideals  to 
the  world  in  novels  and  romances.  In  "  Venus  in  Furs,"  we  find  those 
that  are  like  us  in  feeling, — word  for  word,  line  for  line,  are  expressed 
the  ideas  so  familiar  to  us,  which  we  believe  to  be  our  own  exclusive 
discovery. 

Until  then  I  did  not  think  it  possible  that  there  could  be,  in  any 
other  brain  than  mine,  the  lustful  thought  of  being  harnessed  to  a  plow 
and  made  to  work  like  a  draught-horse. 

And  the  ill-temper  of  the  mistress  to  be  served  at  the  toilet  and 
bath ;  the  imprisonment, — ah,  how  familiar  such  ideas  are  to  us  from 
childhood  1 

Therefore,  perhaps  by  reason  of  this  open  disclosure  of  things  that 
should  be  secret,  the  reading  of  this  book  shocks  masochists,  undeceives 
them,  and  exerts  a  curative  influence. 

Finally,  I  should  mention  that,  according  to  my  experience,  the 
number  of  masochists,  especially  in  large  cities,  seems  to  be  quite  large. 
The  only  sources  of  such  information  are — since  men  do  not  reveal 
these  things — words  of  prostitutes;  and,  since  they  agree  on  the  essen- 
tial points,  it  may  be  concluded  that  certain  facts  are  proved. 

Thus  there  is  the  fact  that  every  experienced  prostitute  is  accus- 
tomed to  keep  some  suitable  instrument  (usually  a  whip)  for  flagellation  ; 
but  it  must  be  remembered  that  there  are  men  who  have  themselves 
whipped  simply  to  increase  their  sexual  pleasure;  who,  in  contrast  with 
masochists,  regard  flagellation  as  a  means  to  an  end. 

On  the  other  hand,  almost  all  prostitutes  agree  that  there  are 
many  men  who  like  to  play  "  slave," — i.e.,  like  to  be  so  called,  and  have 
themselves  scolded  and  trod  upon  and  beaten.  As  has  been  said,  the 
number  of  masochists  is  larger  than  has  yet  been  dreamed. 

As  you  can  imagine,  reading  the  "New  Investigations 'n  made  a 

1  The  author's  "  Neue  Forschungen  auf  d.  Geblet  d.  Psychopathia  Sexualis,"  Stutt- 
gart, 1891,  which  is,  for  the  most  part,  incorporated  in  this  edition  of  "  Psychopathia  Sex- 
ualis." 


108  PSYCHOPATHIA   SEXUALIS. 

great  impression  on  me.  I  should  like  to  have  faith  in  a  cure,  in  a  logical 
cure,  so  to  speak,  in  accordance  with  the  motto  :  "  Tout  comprendre  c'est 
tout  guerir."     (To  understand  all  is  to  cure  all.) 

Of  course  the  word  cure  is  to  be  taken  with  some  limitation,  and 
there  must  be  a  distinction  made  between  general  feelings  and  concrete 
ideas.  The  former  can  never  be  overcome ;  they  come  like  a  stroke  of 
lightning,  are  there,  and  one  does  not  know  whence  or  how. 

But  this  practice  of  masochism  in  imagination,  by  means  of  con- 
crete, associated  ideas,  can  be  avoided,  or  at  least  restricted. 

Now  the  thing  is  changed.  I  say  to  myself:  What!  you  busy  your 
mind  with  things  which  not  onby  the  aesthetic  sense  of  others,  but  also 
your  own,  disapproves?  You  regard  that  as  beautiful  and  desirable 
which,  in  your  own  judgment,  is  at  once  ugly,  coarse,  silly,  and  impos- 
sible ?  You  long  for  a  situation  which  in  reality  you  can  never  obtain  ? 
This  opposing  idea  has  an  immediate  inhibitory  and  undeceiving  effect, 
and  takes  the  edge  off  the  fancy.  Too,  since  reading  the  "  New  In- 
vestigations "  (early  this  year),  I  have  actually  not  reveled  in  my 
fancy  once,  though  the  masochistic  tendency  has  occurred  with  regu- 
larity. 

I  must  also  confess  that,  in  spite  of  its  marked  pathological  char- 
acter, masochism  is  not  only  incapable  of  destroying  my  pleasure  in  life, 
but  it  does  not  in  the  least  affect  my  outward  life.  When  not  in  a  maso- 
chistic state,  as  far  as  feeling  and  action  are  concerned,  I  am  a  perfectly 
normal  man.  During  the  activity  of  the  masochistic  tendencies  there  is, 
of  course,  a  great  revolution  in  my  feeling,  but  m}r  outward  manner  of 
life  suffers  no  change ;  I  have  a  calling  that  makes  it  necessary  for  me  to 
move  much  in  public,  and  I  pursue  it  in  the  masochistic  condition  as 
well  as  ever. 

The  author  of  the  foregoing  lines  also  sends  me  the  follow- 
ing notes : — 

1.  Masochism,  according  to  my  experience,  is,  under  all  circum- 
stances, congenital,  and  never  acquired  by  the  individual.  I  know  posi- 
tively that  I  was  never  spanked;  that  my  masochistic  ideas  were  mani- 
fested from  my  earliest  youth  ;  and  that,  as  long  as  I  have  been  capable 
of  thinking,  I  have  had  such  thoughts.  If  the  origin  of  them  had 
been  the  result  of  a  particular  event,  especially  of  a  beating,  I  should 
certainty  not  have  forgotten  it.  It  is  characteristic  that  the  ideas  were 
present,  before  there  was  any  libido.  At  that  time  the  ideas  were  abso- 
lutely sexless.  I  remember  that,  when  a  boy,  it  affected  (not  to  say 
excited)  me  intensely  when  an  older  boy  addressed  me  in  the  second 
person  (Da),  while  I  spoke  to  him  in  the  third  (Sie).  I  would  keep  up  a 
conversation  with  him,  and  have  the  exchange  of  address  take  place  as 
often  as  possible.     Later,  when  1  had  become  more  mature  sexually,  such 


MASOCHISM.  109 

things  affected  me  only  when  they  occurred  with  a  married  woman,  and 
one  relatively  old. 

2.  Physically  and  mentally  I  am  in  all  respects  masculine.  I  have 
a  superabundant  growth  of  beard,  and  my  whole  bodj'  is  very  hairy.  In 
my  relations  to  the  female  sex  that  are  not  masochistic,  the  dominating 
position  of  the  man  is  an  indispensible  condition,  and  any  attempt  to 
change  it  would  meet  with  my  energetic  opposition.  I  am  energetic,  if 
not  over-courageous  ;  but  the  want  of  courage  is  not  manifest  when  my 
pride  is  injured.  I  am  not  sensitive  to  events  in  nature  (thunder-storms, 
storms  at  sea,  etc.).1 

Too,  my  masochistic  tendencies  have  nothing  feminine  or  effemi- 
nate about  them  (?).  To  be  sure,  in  these  the  inclination  to  be  sought  and 
desired  by  the  woman  is  dominant;  but  the  general  relation  desired 
with  her  is  not  that  in  which  a  woman  stands  to  a  man,  but  that  of  the 
slave  to  the  master,  the  domestic  animal  to  its  owner.  If  one  regards 
the  ultimate  aim  of  masochism  without  prejudice,  it  must  be  acknowl- 
edged that  its  ideal  is  the  position  of  a  dog  or  horse.  Both  are  owned 
by  masters,  and  punished  by  them  ;  and  the  masters  are  responsible  to  no 
one.  Just  this  unlimited  power  of  life  and  death,  as  exercised  over 
slaves  and  domestic  animals,  is  the  end  and  aim  of  all  masochistic  ideas. 

3.  The  foundation  of  all  masochistic  ideas  is  libido  ;  and  as  this  ebbs 
and  flows,  so  do  the  masochistic  fancies.  On  the  other  hand,  as  soon  as 
the  ideas  are  present,  they  greatly  intensify  the  libido.  I  am  by  no 
means  excessively  sensual  natural^.  However,  when  the  masochistic 
ideas  occur,  I  am  impelled  to  coitus  at  any  cost  (for  the  most  part  I  am 
driven  to  the  lowest  women);  and  if  these  impulses  are  not  soon  obeyed, 
libido  soon  becomes  almost  satyriasis.  One  is  almost  justified  in  look- 
ing upon  this  as  a  circulus  vitiosus. 

Libido  occurs  either  in  the  course  of  time,  or  as  the  result  of  espe- 
cial excitement  (also  of  a  kind  that  is  not  masochistic, — e.g.,  kissing). 
In  spite  of  its  manner  of  origin,  this  libido,  by  virtue  of  the  masochistic 
ideas  it  engenders,  is  soon  transformed  into  a  masochistic  and  impure 
libido. 

Moreover,  there  is  no  doubt  that  external,  accidental  impressions, 
particularly  loitering  in  the  streets  of  a  large  city,  greatly  intensify  the 
desire.  The  sight  of  beautiful  and  imposing  female  forms,  in  nature  as 
well  as  in  art,  is  exciting.  For  those  subject  to  masochism, — at  least 
during  the  attacks, — the  whole  external  world  becomes  masochistic. 
The  box  on  the  ear  administered  by  the  teacher  to  the  pupil  and  the  ci'ack 
of  the  driver's  whip  make  deep  impressions  on  the  masochist,  while  they 
leave  him  indifferent  or  annoy  him  when  he  is  not  in  the  masochistic  state. 

1  This  difference  of  courage  in  the  face  of  events  in  nature,  on  the  one  hand,  and 
in  the  face  of  personal  conflict,  on  the  other,  is  certainly  remarkable  (comp.  Case  44),  even 
though  it  is  the  only  indication  of  effemination  mentioned  in  this  case. 


110  PSYCHOPATHIA   SEXUALIS. 

4.  An  example  of  masochistic  ideas  follows :  "  She  "  is  a  peasant 
woman, — a  rough,  tall,  large-boned  woman  of  forty  or  fifty  years.  She  is 
the  possessor  of  a  small,  remote  farm,  which  she  works  with  the  help  of 
her  slave  alone.  The  work  begins  before  sunrise.  At  four  o'clock  in 
the  morning  she  opens  the  shed  where  she  has  kept  me  shut  up  over 
night,  and  wakens  me,  as  I  lie  on  the  ground,  with  a  kick ;  then  she  leads 
me  out  and  harnesses  me  to  a  milk-cart  bound  for  town.  She  leads  me 
by  a  halter,  and  urges  me  along.  On  the  road  she  gets  on  the  heavily- 
loaded  wagon,  and  sleeps  until  the  destination  is  reached.  There,  in  the 
open  market-place  of  the  town,  still  harnessed  to  the  wagon,  I  lie  down 
on  the  bai'e  ground  to  rest.  Those  passing  knock  against  me  or  step  on 
me,  without  giving  me  any  attention.  After  the  stock  is  sold,  we  start 
homeward.  After  a  short  rest  the  work  begins  again,  always  under 
the  direction  of  the  mistress,  who  holds  me  by  the  halter  and  urges  me 
on.  At  seven  or  eight  o'clock  at  night  I  am  put  up  to  rest,  and  sleep 
until  the  next  morning,  when  the  same  thing  begins  again.  Work  and 
blows,  blows  and  work;  no  pleasure,  no  recreation,  day  in  and  day  out! 

Another  time  I  fancy  myself  in  the  role  of  a  paid  lover  of  an 
elderly  female  roue,  who  makes  use  of  me,  sexually,  in  the  most  reckless 
manner ;  and  in  this  direction  makes  the  most  shameful  demands  on  me. 
If  I  do  not  submit  to  these  willingly,  I  am  beaten  and  punished  ;  and,  at 
the  same  time,  she  despises  me  unspeakably ;  gives  me  the  lowest  house- 
work to  do ;  and  on  every  occasion  shows  me  how  low  an  opinion  she 
has  of  m}^  manhood. 

I  cannot  clothe  the  character  of  masochism  in  any  better  formula 
than  the  following  :  A  real  masochist,  without  reflection,  prefers  the 
kick  of  a  low  woman  to  the  embrace  of  a  Venus. 

5.  In  reading  Sacher-Masoch,  it  struck  me  that  in  masochists,  now 
and  then,  there  was  also  an  undercurrent  of  sadistic  feeling.  Too,  I 
have  now  and  then  discovered  in  myself  sporadic  feelings  of  sadism. 
I  must  remark,  however,  that  the  sadistic  feelings  are  not  so  marked  as 
the  masochistic ;  and  that,  aside  from  the  fact  that  they  are  infrequently 
accessory,  the  sadistic  fancies  never  leave  the  sphere  of  abstract  feeling, 
and,  above  all,  never  take  the  form  of  concrete,  connected  ideas  (like 
those  above  mentioned).  The  effect  on  libido,  however,  is  the  same  with 
both. 

If  this  case  is  remarkable  on  account  of  the  complete  de- 
velopment of  the  psychical  state  that  constitutes  masochism,  the 
following  one  is  noteworthy  because  of  the  great  extravagance 
of  the  acts  resulting  from  the  perversion.  The  case  is  also  par- 
ticularly suited  to  make  clear  the  reason  for  the  subjection  and 
humiliation  at  the  hands  of  the  woman,  and  the  peculiar  sexual 
coloring  of  the  resulting  situations ; — 


MASOCHISM.  Ill 

Case  51.  Masochism. — Mr.  Z.,  official,  aged  50 ;  tall,  muscular, 
healthy.  He  is  said  to  come  of  healthy  parentage,  but  his  father  was 
thirty  years  older  than  his  mother.  A  sister,  two  years  older  than  Z., 
sutlers  with  delusions  of  persecution.  There  is  nothing  remarkable  in 
Z.'s  external  appearance.  Skeleton  entirely  masculine  ;  abundant  beard, 
but  no  hair  on  trunk.  He  characterizes  himself  as  a  man  of  sanguine 
temperament,  whom  no  one  can  depress  ;  though  irascible  and  quick- 
tempered, he  is  quick  to  regret  outbursts. 

Z.  says  he  has  never  masturbated.  From  his  youth  there  have  been 
nightly  pollutions,  in  which  girls  play  a  part ;  but  the  sexual  act,  never. 
For  example,  he  dreams  that  a  pleasing  woman  lies  heavily  on  him,  or 
that,  as  he  lies  sleeping  on  the  grass,  she  playfully  walks  up  his  back. 
Z.  had  always  been  averse  to  coitus  with  a  woman.  This  act  seemed 
animal  to  him.  Nevertheless,  he  was  drawn  to  women.  It  was  only  in 
the  society  of  beautiful  women  and  girls  that  he  felt  well  and  in  his  place. 
He  was  very  gallant  without  being  forward. 

A  voluptuous  woman  of  beautiful  form,  and  particularly  with  a 
pretty  foot,  when  seated,  had  the  power  to  throw  him  into  intense  ex- 
citement. He  was  impelled  to  offer  himself  as  a  chair,  in  order  "  to 
offer  so  much  devotion."  A  kick,  a  box  on  the  ear  from  her,  would  be 
heaven  to  him.  He  had  a  horror  at  the  thought  of  coitus  with  her. 
He  felt  the  need  to  serve  the  woman.  He  thought  how  ladies  liked  to 
ride.  He  reveled  in  the  thought  of  how  fine  it  would  be  to  be  wearied 
by  the  burden  of  a  beautiful  woman,  in  order  to  give  her  pleasure.  He 
painted  the  situation  in  all  colors  ;  thought  of  the  beautiful  foot  armed 
with  spurs,  the  beautiful  legs,  and  the  soft,  full  thighs.  Every  beautiful 
mature  woman,  every  pretty  female  foot,  always  excited  his  imagina- 
tion; but  he  never  betrayed  the  peculiar  feelings  that  seemed  to  him 
abnormal,  and  was  able  to  control  himself.  But  he  felt  no  need  to  fight 
against  them  ;  on  the  contrary,  it  would  have  hurt  him  had  he  been  com- 
pelled to  give  up  the  feelings  that  had  become  so  dear  to  him. 

At  the  age  of  thirty-two  Z.  happened  to  make  the  acquaintance  of 
an  attractive  woman,  aged  twenty-seven,  who  had  been  separated  from 
her  husband,  and  whom  he  found  in  need.  He  took  her,  and  worked  for 
her,  without  any  selfish  motive,  for  months.  One  evening  she  impatiently 
demanded  sexual  satisfaction  from  him,  and  almost  used  violence.  Coitus 
was  successful.  Z.  took  the  woman,  lived  with  her,  and  indulged  in 
coitus  moderately ;  but  coitus  was  more  a  burden  than  a  pleasure;  erec- 
tions became  weak,  and  he  could  no  longer  satisfy  the  woman.  She 
finally  declared  that  she  would  not  have  intercourse  with  him,  because  he 
only  excited  without  satisfying  her.  Though  he  loved  the  woman  very 
much,  he  could  not  give  up  his  peculiar  fancies.  After  this  he  lived 
with  her  only  in  friendly  relations,  and  deeply  regretted  that  he  could 
not  serve  her  in  the  way  she  desired. 

Fear  of  how  she  would  receive  his  propositions,  and  a  feeling  of 


112  PSTCHOPATHIA   SEXUALIS. 

shame,  kept  him  from  confessing.  He  found  a  substitute  in  his  dreams. 
Thus,  for  example,  he  dreamed  that  he  was  a  proud,  fiery  steed,  ridden 
bjT  a  beautiful  lady.  He  felt  her  weight,  the  bit  he  had  to  obey,  the  press- 
ure of  the  thighs  on  his  flanks;  he  heard  her  beautiful,  joyous  voice. 
The  exertion  threw  him  into  a  perspiration  ;  the  touch  of  the  spurs 
did  the  rest,  and  always  induced  pollution  with  great  lustful  pleasure. 
At  other  times  he  dreamed  that  he  was  a  small,  weak  horse.  Then  a 
large,  heavy  woman  came  and  mounted  the  horse,  and  set  off  on  a  long 
journey  in  the  mountains.  Recklessly,  and  without  mercy,  she  allowed 
the  poor  animal  to  feel  her  weight ;  she  made  herself  comfortable 
on  his  back ;  while  he  threatened  to  give  out  under  her,  she  had  the 
greatest  enjoyment,  and  with  calm  mind  enjoyed  the  beautiful  scenery. 
Under  the  influence  of  such  dreams,  seven  years  ago  Z.  overcame  his 
reluctance,  in  order  to  experience  such  things  in  reality.  He  was  suc- 
cessful in  creating  suitable  opportunity.  He  speaks  of  it  as  follows  :  "  I 
knew  how  to  arrange  it  so  that  on  an  occasion  she  would,  of  her  own 
will,  seat  herself  on  my  back.  Then  I  endeavored  to  make  this  situation 
as  pleasant  as  possible,  and  easily  made  it  so  that  on  the  next  occasion 
she  said,  spontaneously  :  '  Come,  give  me  a  little  ride  1 '  Swelling  with 
pride,  and  with  both  hands  braced  on  a  chair,  I  made  my  back  horizontal, 
and  she  mounted  astride,  after  the  manner  of  a  man.  I  then  did  the  best 
I  could  to  imitate  the  movements  of  a  horse,  and  loved  to  have  her  treat 
me  like  a  horse,  without  any  thought  of  me.  She  could  beat,  prick, 
scold,  or  caress  me,  just  as  she  felt  inclined.  I  could  carry  on  my  back 
persons  weighing  from  sixty  to  eighty  kilos,  for  half  or  three-quarters  of 
an  hour,  without  interruption.  At  the  end  of  this  time  I  usually  asked 
for  a  rest.  During  this  the  intercourse  between  the  mistress  and  me  was 
perfectly  harmless  and  without  any  relation  to  what  had  preceded.  After 
about  a  quarter  of  an  hour  I  was  always  rested,  and  placed  myself  at  the 
disposal  of  the  mistress  again.  When  time  and  circumstances  allowed  it,  I 
did  this  three  or  four  times  in  succession.  It  sometimes  happened  that 
I  practiced  it  both  in  the  morning  and  afternoon.  After  it  I  never  felt 
weary  or  had  any  uncomfortable  feeling ;  but  on  such  days  I  had  very  little 
appetite.  When  possible,  I  liked  best  to  bare  my  trunk,  that  I  might  feel 
the  rider  more  perfectly.  The  mistress  had  to  be  decent.  I  liked  her 
best  in  pretty  shoes  and  stockings,  with  short,  closed  drawers,  reaching 
to  the  knee ;  with  the  upper  portion  of  her  person  completely  dressed, 
and  with  hat  and  gloves." 

Mr.  Z.  further  says  that  he  has  not  performed  coitus  in  seven  years ; 
but  he  thinks  he  is  potent.  The  riding  was  a  perfect  substitute  for  that 
"  animal  act,"  even  when  ejaculation  was  not  induced. 

For  eight  months  Z.  had  determined  to  give  up  his  masochistic  play, 
and  had  kept  his  determination.  But  he  thought  that  if  a  woman  only 
half-way  pretty  were  to  address  him  directly,  and  say,  "  Come,  I  want 
to  ride  you,"  he  would  not  be  strong  enough  to  withstand  the  tempta- 


MASOCHISM.  113 

tion.     Z.  wishes  to  know  whether  his  abnormality  is  curable ;  whether 
he  is  unworthy  as  a  vicious  man,  or  an  invalid  deserving  pity. 

The  following  case  seems  very  similar : — 

Case  52.  A  man  finds  satisfaction  in  the  following  manner :  Occa- 
sionally he  goes  to  a  pnella  publica.  Here  he  has  a  porcelain  ring,  like 
those  used  in  hanging  curtains,  put  on  his  penis.  Two  cords  are  attached 
to  the  ring  and  drawn  backward  between  his  legs  and  attached  to  the 
bedstead.  Then  he  tells  the  woman  to  beat  him  mercilessly  with  a  whip 
and  cry  "  whoa  "  to  him  constantly,  and  treat  and  abuse  him  as  if  he 
were  an  unruly  horse.  The  more  the  woman  spurs  him  on  to  pull,  with 
shouts  and  blows,  the  greater  his  sexual  excitement  becomes.  Erection 
occurs  (probably  mechanically  favored  by  compression  of  the  dorsal 
vein  of  the  penis,  which,  when  the  cords  are  strained,  must  be  closed  by 
the  pressure  of  the  hard  ring).  With  increasing  erection,  the  whole 
member  is  compressed  by  the  ring,  and  finally  ejaculation  occurs,  with 
lustful  feeling. 

Even  in  the  foregoing  series  of  cases,  with  other  things, 
the  act  of  being  walked  upon  has  played  a  role  as  a  means  of 
expressing  the  masochistic  situations  of  humiliation  and  pain. 
The  exclusive  and  most  extensive  use  of  this  means  for  perverse 
excitation  and  satisfaction  is  shown  in  the  following  classical 
case  of  masochism,  which  Hammond  reports  (op.  cit.,  p.  28) 
from  an  observation  by  Dr.  Cox,1  of  Colorado : — 

Case  53.  X.,  a  model  husband,  very  moral,  the  father  of  several 
children,  has  times — i.e.,  attacks — in  which  he  visits  brothels,  chooses 
two  or  three  of  the  largest  girls,  and  shuts  himself  up  with  them.  He 
bares  the  upper  portion  of  his  body,  lies  down  on  the  floor,  crosses  his 
hands  on  his  abdomen,  closes  his  eyes,  and  then  has  the  girls  walk  over 
his  naked  breast,  neck,  and  face,  urging  them  at  every  step  to  press  hard 
on  his  flesh  Avith  the  heels  of  their  shoes.  Sometimes  he  wants  a  heavier 
girl,  or  some  other  act  still  more  cruel  than  this  procedure.  After  two 
or  three  hours  he  has  enough.  He  pays  the  girls  with  wine  and  money, 
rubs  his  blue  bruises,  dresses  himself,  pays  his  bill,  and  goes  back  to  his 
business,  only  to  give  himself  the  same  strange  pleasure  again  after  a 
few  weeks. 

Occasionally  it  happens  that  he  has  one  of  the  girls  stand  on  his 
breast;  and  the  others  then  turn  her  around  until  his  skin  is  torn  and 
bleeding  from  the  turning  of  the  heels  of  her  shoes.     Frequently  one  of 

1  Transactions  of  the  Colorado  State  Medical  Society,  quoted  in  the  Alienist  and 
Neurologist,  1883,  p.  345. 


114  PSYCHOPATHIA    SEXUALIS. 

the  girls  has  to  stand  on  him  in  such  a  way  that  one  shoe  is  over  the 
eyes,  with  its  heel  pressing  on  one  e37e,  while  the  other  rests  across  his 
neck.  In  this  position  he  endures  the  pressure  of  a  person  weighing 
about  one  hundred  and  fifty  pounds  for  four  or  five  minutes.  The  author 
speaks  of  dozens  of  similar  cases  that  are  known  to  him.  Hammond 
presumes,  with  reason,  that  this  man  had  become  impotent  for  inter- 
course with  women ;  that,  in  this  strange  procedure,  he  found  an  equiva- 
lent for  coitus ;  and  that,  when  the  heels  drew  blood,  he  had  pleasant 
sexual  feelings,  accompanied  b}'  ejaculation. 

The  ten  cases  of  masochism  thus  far  described,  and  the 
numerous  analogous  cases  mentioned  by  those  who  report  them, 
form  a  counterpart  to  the  previously  described  group  "c"  of 
sadism.  Just  as  in  sadism  men  excite  and  satisfy  themselves  by 
maltreating  women,  so  in  masochism  the  same  effect  is  sought 
in  the  passive  reception  of  similar  abuse.  But  group  "a"  of  the 
sadists, — that  of  lust-murder, — strange  as  it  may  seem,  is  not 
without  its  counterpart  in  masochism.  In  its  extreme  conse- 
quences, masochism  must  lead  to  the  desire  to  be  killed  by  a 
person  of  the  opposite  sex,  in  the  same  way  that  sadism  has  its 
acme  in  active  lust-murder.  But  the  instinct  of  self-preservation 
opposes  such  a  result ;  so  that  the  extreme  is  not  actually  car- 
ried out.  When,  however,  the  whole  structure  of  masochistic 
ideas  is  purely  psychical,  in  the  imagination  of  such  individuals, 
even  the  extreme  may  be  reached;  as  the  following  case 
shows : — 

Case  54.  A  middle-aged  man,  married  and  the  father  of  a  family, 
who  has  always  led  a  normal  vita  sexualis,  but  who  says  he  comes  of  a 
very  nervous  family,  makes  the  following  communication  :  In  his  early 
youth  he  was  powerfully  excited  sexually  at  the  sight  of  a  woman 
slaughtering  an  animal  with  a  knife.  From  that  time,  for  many  years, 
he  had  reveled  in  the  lustfulby-colored  idea  of  being  stabbed  and  cut 
and  even  killed  by  women  with  knives.  Later,  after  the  beginning  of 
normal  sexual  intercourse,  these  ideas  lost  completely  their  perverse 
stimulus  for  him. 

This  case  should  be  compared  with  the  statements  made 
under  Case  44,  according  to  which  men  find  sexual  pleasure  in 
being  lightly  pricked  with  knives  in  the  hands  of  women,  who, 
at  the  same  time,  threaten  them  with  death. 

Such  fancies,  perhaps,  give  the  key  to  an  understanding  of 


MASOCHISM.  115 

the  following  strange  case,  for  which  I  am  indebted  to  a  com- 
munication from  Dr.  Korber,  of  Rankau : — 

Case  55.  A  lady  makes  me  the  following  communication  :  While 
still  a  young  and  innocent  girl,  she  was  married  to  a  man  of  about  thirty 
years.  On  their  wedding-night  he  forced  a  towel  and  soap  into  her 
hands,  and,  without  any  other  expression  of  love,  wanted  her  to  lather 
his  chin  and  neck  (as  if  for  shaving).  The  inexperienced  young 
wife  did  it,  and  was  not  a  little  astonished,  during  the  first  weeks 
of  married  life,  to  learn  its  secrets  in  absolutely  no  other  form.  Her 
husband  always  told  her  that  it  gave  him  the  greatest  delight  to  have 
his  face  lathered  by  her.  Later,  after  she  had  sought  the  advice  of 
friends,  she  induced  her  husband  to  perform  coitus,  and  had  three  chil- 
dren in  the  course  of  time  (by  him,  she  states  with  every  assurance).  The 
husband  is  industrious  and  reliable,  but  a  moody  man,  with  little  perse- 
verance ;  by  occupation  a  merchant. 

It  may  be  inferred  that  this  man  conceived  the  act  of  being 
shaved  (i.e.,  the  lathering  as  a  preparatory  measure)  as  a  rudi- 
mentary, symbolic  realization  of  ideas  of  injury  or  death,  or  of 
fancies  about  knives;  like  those  the  man  previously  mentioned 
had  had  in  his  youth,  and  by  means  of  which  he  had  been 
sexually  excited  and  satisfied.  The  perfect  sadistic  counterpart 
to  this  case,  looked  upon  in  this  light,  is  offered  by  Case  35, 
which  is  a  case  of  symbolic  sadism. 

At  any  rate,  there  is  a  whole  group  of  masochists  who 
satisfy  themselves  with  the  symbolic  representations  of  situations 
corresponding  with  their  perversion ;  a  group  that  corresponds 
with  group  "e"  of  "symbolic"  sadists,  just  as  the  previously 
mentioned  cases  of  masochism  correspond  with  the  groups  "c" 
and  "  a  "  of  sadism.  Thus,  just  as  the  perverse  longings  of  the 
masochist  may,  on  the  one  hand,  advance  to  "  passive  lust- 
murder"  (to  be  sure,  only  in  imagination);  so,  on  the  other 
hand,  they  may  be  satisfied  with  simple  symbolic  representations 
of  the  desired  situations,  which  otherwise  are  expressed  in  acts 
of  cruelty  (this,  of  course,  taken  objectively,  goes  much  further 
than  the  idea  of  being  murdered,  but  in  fact  not  so  far,  owing 
to  the  determining  subjective  conditions). 

With  Case  55,  other  similar  cases  should  be  here  described, 
in  which  the  acts  desired  and  planned  by  the  masochist  have  a 


116  PSYCHOPATHIA    SEXUALIS. 

purely  symbolic  character,  and,  to  a  certain  extent,  serve  to  indi- 
cate the  desired  situation. 

Case  56.  (Pascal,  "  Igiene  dell'  amore.")  Every  three  months  a 
man  of  about  forty-five  3Tears  would  visit  a  certain  prostitute,  and  pay 
her  ten  francs  for  the  following  act.  The  puella  had  to  undress  him,  tie 
his  hands  and  feet,  bandage  his  eyes,  and  draw  the  curtains  of  the  win- 
dows. Then  she  would  have  her  guest  sit  down  on  a  sofa,  and  had  to 
leave  him  there  alone.  After  half  an  hour  she  had  to  come  back  and  un- 
bind him.  Then  the  man  would  pay  her  and  leave  perfectly  satisfied,  to 
repeat  his  visit  in  about  three  months. 

In  the  dark  this  man  seems  to  have  extended  this  situation, 
of  being  helpless  in  the  hands  of  a  woman,  further  in  imagina- 
tion. The  following  case,  in  which  again  a  complicated  comedy, 
in  the  sense  of  masochistic  desires,  is  played,  is  still  more  pecu- 
liar : — 

Case  57.  (Dr.  Pascal,  ibid.)  A  gentleman  in  Paris  was  accustomed 
to  call  on  certain  evenings  at  a  house  where  a  woman,  the  owner,  acceded 
to  his  peculiar  desire.  He  entered  the  salon  in  full-dress,  and  she, 
likewise  in  evening  toilette,  hud  to  receive  him  with  a  very  haughty  manner. 
He  addressed  her  as  "Marquise,"  and  she  had  to  call  him  "dear  Count." 
Then  he  spoke  of  his  good  fortune  in  finding  her  alone,  of  his  love  for 
her,  and  of  a  lover's  rendezvous.  At  this  the  lady  had  to  feel  insulted. 
The  pseudo-count  grew  bolder  and  bolder,  and  asked  the  pseudo-mar- 
quise for  a  kiss  on  her  shoulder.  There  is  an  angry  scene ;  the  bell  is 
rung;  a  servant,  prepared  for  the  occasion,  appears,  and  throws  the 
count  out  of  the  house.  He  departs  well  satisfied,  and  pays  the  actors 
in  the  farce  handsomely. 

In  connection  with  this  case  of  symbolic  masochism,  two 
more  are  here  given,  in  which  the  psychical  perversion  was  en- 
tirely confined  to  the  sphere  of  thought  and  imagination,  and  no 
realization  was  attempted.  The  first  is  that  of  an  individual, 
mentally  and  physically  predisposed,  bearing  degenerative  signs, 
in  whom  mental  and  physical  impotence  occurred  early : — 

Case  58.  Mr.  Z.,  aged  22,  single,  was  brought  to  me  by  his  father 
for  medical  advice,  because  he  was  very  nervous  and  apparently  abnor- 
mal sexually.  Mother  and  maternal  grandmother  were  insane.  His 
father  begat  him  at  a  time  when  he  was  suffering  severely  nervously. 

Patient  is  said  to  have  been  a  very  lively  and  talented  child.  At  the 
age  of  seven  he  was  noticed  to  practice  masturbation.     After  his  ninth 


MASOCHISM.  117 

year  he  became  inattentive,  forgetful,  and  did  not  progress  in  his  studies, 
constantly  requiring  help  and  protection.  With  difficulty  he  got  through 
the  Gymnasium,  and  during  his  time  of  freedom  had  attracted  attention 
by  his  indolence,  absent-mindedness,  and  various  foolish  acts. 

Consultation  was  occasioned  by  an  occurrence  on  the  street,  in 
which  Z.  had  forced  himself  on  a  young  girl  in  a  very  impetuous  manner, 
and  in  great  excitement  had  tried  to  have  a  conversation  with  her. 

The  patient  gave  as  a  reason,  that,  by  conversing  with  a  respectable 
girl,  he  wished  to  excite  himself  so  that  he  could  be  potent  in  coitus  with 
a  prostitute ! 

His  father  characterizes  him  as  a  man  of  perfectly  good  disposition, 
moral,  but  lazy,  and  dissatisfied  with  himself;  as  one  often  in  despair 
about  his  want  of  success  in  life  ;  as  indolent,  and  interested  in  nothing 
but  music,  for  which  he  possesses  great  talent. 

The  patient's  exterior — his  plagiocephalic  head  ;  his  large,  promi- 
nent ears ;  the  deficient  innervation  of  the  right  facialis  about  the  mouth  ; 
the  neuropathic  expression  of  the  eyes — indicates  a  degenerate,  neuro- 
jpathic  individual. 

Z.  is  tall,  of  powerful  frame,  and,  in  all  respects,  of  masculine  ap- 
pearance. Pelvis  masculine;  testicles  well  developed  ;  penis  remarkably 
large  ;  mons  veneris  with  abundant  hair.  The  right  testicle  hangs  much 
lower  than  the  left ;  the  cremasteric  reflex  is  weak  on  both  sides.  The 
patient  is  below  the  average  intellectually.  He  feels  his  deficiency, 
complains  of  his  indolence,  and  asks  to  have  his  will  strengthened. 
His  awkward,  embarrassed  manner,  timid  glances,  and  relaxed  attitude, 
point  to  masturbation.  The  patient  confesses  that  from  his  seventh 
year,  until  a  year  and  a  half  ago,  he  practiced  it,  years  at  a  time,  from 
eight  to  ten  times  daily.  Until  a  few  years  ago,  when  he  became  neuras- 
thenic (cephalic  pressure,  loss  of  mental  power,  spinal  irritation,  etc.), 
he  says  he  always  found  great  sensual  pleasure  in  it.  Since  then  this  had 
been  lost,  and  the  desire  to  masturbate  had  disappeared.  He  had  con- 
stantly grown  more  bashful  and  indolent,  less  energetic,  and  more 
cowardly  and  apprehensive.  He  had  lost  interest  in  everything,  and  did 
his  business  only  from  a  sense  of  duty,  feeling  very  low-spirited.  He 
had  never  thought  of  coitus,  and,  from  his  stand-point  as  an  onanist,  he 
could  not  understand  how  others  could  find  pleasure  in  it. 

Investigations  in  the  direction  of  contrary  sexual  instinct  gave  a 
negative  result.  He  says  he  never  was  drawn  toward  persons  of  his 
own  sex ;  he  rather  thinks  that  he  has  now  and  then  had  a  weak  inclina- 
tion for  females.  He  asserts  that  he  came  to  masturbate  independently. 
In  his  thirteenth  year  he  first  noticed  ejaculations  as  a  result  of  mastur- 
batic  manipulations. 

It  was  only  after  long  persuasion  that  Z.  consented  to  entirely 
unveil  his  vita  sexualis.  As  his  statements,  which  follow,  show,  he  may 
be  classified  as  a  case  of  ideal  masochism,  with  rudimentary  sadism. 


118  PSYCHOPATSIA   SEXUALIS, 

The  patient  distinctly  remembers  that,  at  the  age  of  six,  without  any 
cause,  he  had  "  ideas  of  violence."  He  was  compelled  to  imagine  that  a 
servant-girl  spread  his  legs  apart  and  showed  his  genitals  to  another ; 
that  she  tried  to  throw  him  into  cold  or  hot  water,  in  order  to  cause  him 
pain.  These  "  ideas  of  violence  "  were  attended  with  lustful  feeling,  and 
became  the  cause  of  masturbatic  manipulations.  Later  the  patient 
called  them  up  voluntarily,  in  order  to  incite  himself  to  masturbation. 
They  also  played  a  part  in  his  dreams  ;  but  they  never  induced  pollution, 
apparently  because  the  patient  masturbated  excessively  during  the  da}'. 

In  time,  to  these  masochistic  "  ideas  of  violence,"  others  of  a  sadistic 
nature  were  added.  At  first  the}1-  were  scenes  in  which  boys  forcibty 
practiced  onanism  on  one  another,  or  cut  off  the  genitals.  He  often 
imagined  himself  such  a  boy,  now  in  an  active,  now  in  a  passive,  role. 
Later  he  busied  himself  with  mental  pictures  of  girls  and  women  "tlmt 
exhibited  themselves  to  one  another.  He  reveled  in  the  thought,  for 
example,  of  a  servant-girl  spreading  another  girl's  legs  apart  and  pulling 
the  genital  hair;  or  in  the  thought  of  boys  treating  girls  cruelly,  and 
pricking  and  pinching  their  genitals. 

Such  ideas  also  always  induced  sexual  excitement,  but  he  never 
experienced  any  impulse  to  cany  them  out  activel}'  or  to  have  them 
performed  on  himself  passivelj*.  It  satisfied  him  to  use  them  for  mastur- 
bation. Since  a  year  and  a  half  ago,  with  diminishing  sexual  imagination 
and  libido,  these  ideas  and  impulses  had  become  infrequent,  but  their 
content  remained  unchanged.  The  masochistic  "  ideas  of  violence  "  pre- 
dominated over  the  sadistic.  Now,  when  he  sees  a  lad}-,  he  has  the 
thought  that  she  has  sexual  ideas  like  his  own.  In  this  way,  in  part,  he 
explains  his  embarrassment  in  social  intercourse.  Owing  to  the  fact 
that  he  had  heard  that  he  would  get  rid  of  his  burdensome  sexual  ideas, 
if  he  were  to  accustom  himself  to  natural  sexual  indulgence,  during  the 
last  year  and  a  half  he  has  twice  attempted  coitus  though  he  only 
experienced  repugnance,  and  was  not  confident  of  success.  On  both 
occasions  the  attempt  was  a  fiasco.  The  second  time  he  made  the 
attempt,  he  felt  such  aversion  that  he  pushed  the  girl  awa}-  and  fled. 

The  second  case  is  the  following  one,  placed  at  my  disposal 
by  a  colleague.  Even  though  it  be  aphoristic,  it  seems  particu- 
larly suited  to  throw  a  clear  light  on  the  distinctive  element  of 
masochism, — the  consciousness  of  subjection,  in  its  peculiar 
psycho-sexual  effect : — 

Case  59.  Masochism. — Z.,  aged  27,  artist.  He  is  powerfully  built, 
of  pleasing  appearance,  and  is  said  to  be  free  from  hereditary  taint. 
Healthy  in  youth,  since  his  twenty-third  year  he  has  been  nervous  and 
inclined  to  be  hypochondriacal.    Though  inclined  to  indulgence  sexually, 


MASOCHISM.  119 

he  is  not  very  virile.  In  spite  of  associations  with  females,  his  relations 
with  them  are  limited  to  innocent  attentions.  At  the  same  time,  his 
desire  to  devote  himself  to  women  that  are  cold  toward  him  is  remark- 
able. Since  his  twenty-fifth  year  he  has  noticed  that  females,  no  matter 
how  Ugly,  always  excite  him  sexually,  whenever  he  discovers  anything 
domineering  in  their  character.  An  angry  word  from  the  lips  of  such  a 
woman  is  sufficient  to  give  him  the  most  violent  erections.  Thus,  one 
day,  he  sat  in  a  cafe  and  heard  the  (ugly)  female  cashier  scold  the  waiters 
in  a  loud  voice.  This  threw  him  into  the  most  intense  sexual  excite- 
ment, which  soon  induced  ejaculation.  Z.  requires  the  women,  with 
whom  he  is  to  have  sexual  intercourse,  to  repulse  and  annoy  him  in 
various  ways.  He  thinks  that  only  a  woman  like  the  heroines  of  Sacher- 
Masoch's  romances  could  charm  him. 

Cases  like  this,  in  which  the  whole  perversion  of  the  vita 
sexualis  is  confined  to  the  sphere  of  imagination, — to  the  inner 
world  ol  thought  and  instinct, — and  only  accidentally  comes  to 
the  knowledge  of  others,  do  not  seem  to  be  infrequent.  Their 
'practical  significance,  like  that  of  masochism  in  general  (which 
has  not  the  great  forensic  importance  of  sadism),  is  confined  to 
the  psychical  impotence  to  which  such  individuals,  as  a  rule, 
become  subject ;  and  to  the  intense  impulse  to  solitary  indul- 
gence, with  adequate  imaginary  ideas,  and  its  results. 

That  masochism  is  a  perversion  of  uncommonly  frequent 
occurrence  is  sufficiently  shown  by  the  relatively  large  number 
of  cases  that  have  thus  far  been  studied  scientifically,  as  well  as 
by  the  agreement  of  the  various  statements  reported. 

The  works  concerning  prostitution  in  large  cities  also  con- 
tain numerous  statements  concerning  this  matter. 

Leo  Taxil  (op.  cit.,  p.  228)  describes  masochistic  scenes  in 
Parisian  brothels.  The  man  affected  with  this  perversion  is 
there  also  called  "  slave." 

Coffignon  ("  La  corruption  a  Paris  ")  has  a  chapter  in  his 
book  entitled  "  Les  Passionels,"  which  contains  contributions  to 
this  subject. 

It  is  interesting  and  worthy  of  mention,  that  one  of  the 
most  celebrated  of  men  was  subject  to  this  perversion,  and 
describes  it  in  his  autobiography  (though  somewhat  erroneously). 
From  "  Jean  Jacques  Rousseau's  Confessions  "  it  is  evident  that 
he  was  affected  with  masochism. 


120  PSYCHOPATHIA   SEXUALIS. 

Rousseau,  with  reference  to  whose  life  and  malady  Mobius  ("  J.  J. 
Rousseau's  Krankengeschichte,"  Leipzig,  1889)  and  Chatelain  ("  La  folie 
de  J.  J.  Rousseau,"  Neuchatel,  1890)  may  be  consulted,  tells,  in  his  "  Con- 
fessions" (part  i,  book  i),  how  Miss  Lambercier,  aged  thirty,  greatly  im- 
pressed him  when  he  was  eight  years  old  and  lived  with  her  brother  as 
his  pupil.  Her  solicitude,  when  he  could  not  immediately  answer  a 
question,  and  her  threats  to  punish  him  if  he  did  not  learn  well,  made 
the  deepest  impression  on  him.  When,  one  day,  he  had  blows  at  her 
hands,  with  the  feeling  of  pain  and  shame,  he  also  experienced  sensual 
pleasure  that  incited  a  great  desire  to  be  whipped  by  her  again.  It  was 
only  for  fear  of  disturbing  the  lady,  that  Rousseau  failed  to  make  other 
opportunities  to  experience  this  lustful,  sensual  feeling.  One  day,  how- 
ever, he  unintentionally  gave  cause  for  a  whipping  at  Miss  Lambercier's 
hands.  This  was  the  last ;  for  Miss  Lambercier  must  have  noticed 
something  of  the  peculiar  effect  of  the  punishment ;  and  from  this  time 
on  she  did  not  allow  the  eight-year-old  boy  to  sleep  in  her  room.  From 
this  time  Rousseau  felt  a  desire  to  have  himself  punished  by  ladies 
pleasing  to  him,  a  la  Lambercier ;  but  he  asserts  that  until  his  youth  he 
knew  nothing  of  the  relation  of  the  sexes  to  each  other.  As  is  known, 
Rousseau  was  first  introduced  to  the  real  nvysteries  of  love  in  his 
thirtieth  year,  and  lost  his  innocence  through  Madame  de  Warrens. 
Until  that  time  he  had  had  only  feelings  and  impulses  attracting  him  to 
woman,  in  the  nature  of  passive  flagellation  and  other  masochistic  ideas. 

Rousseau  describes,  in  extenso,  how  he  suffered,  with  his 
great  sexual  desires,  by  reason  of  his  peculiar  sensuality,  which 
had  undoubtedly  been  awakened  by  his  whippings;  for  he 
reveled  in  desire,  and  could  not  disclose  his  longings.  It  would 
be  erroneous,  however,  to  suppose  that  Rousseau  was  concerned 
merely  with  flagellation.  Flagellation  only  awakened  ideas  of  a 
masochistic  nature.  At  least,  in  these  ideas  lies  the  psychological 
nucleus  of  his  interesting  study  of  self.  The  essential  element 
with  Rousseau  was  the  feeling  of  subjection  to  the  woman.  This 
is  clearly  shown  by  the  "Confessions,"  in  which  he  expressly 
emphasizes  that  "  Eire  aux  genoux  (Tune  maitresse  imperieuse, 
obeir  a  ses  ordres,  avoir  des  pardons  a  lui  demander, — etaient 
pour  moi  de  tres  donees  jouissances"  * 

This  passage  proves  that  the  consciousness  of  subjection  and 
humiliation  before  the  woman  was  the  most  important  element. 

1  "  To  be  at  the  feet  of  an  imperious  mistress  ;  to  obey  her  orders  ;  to  be  compelled 
to  sue  her  for  pardon, — these  things  are  my  most  intense  delight." 


MASOCHISM.  121 

To  be  sure,  Rousseau  was  himself  in  error  in  supposing 
that  this  impulse  to  be  humiliated  before  a  woman  had  arisen 
by  association  of  ideas  from  the  idea  of  flagellation : — 

"  N'osant  jamais  declarer  mon  gout,  je  l'amusais  du  moins 
par  des  rapports  qui  m'en  conservaient  l'idee." 1 

It  is  only  in  connection  with  the  numerous  cases  of  maso- 
chism, the  existence  of  which  has  now  been  established,  and 
among  which  there  are  so  many  that  are  in  nowise  connected 
with  flagellation,  showing  the  primary  and  pure  psychical  char- 
acter of  this  instinct  of  subjection, — it  is  only  in  connection  with 
these  cases  that  a  complete  insight  into  Rousseau's  case  is  ob- 
tained, and  the  error  detected  into  which  he  necessarily  fell  in 
the  analysis  of  his  own  condition. 

Binet  {Revue  Anthropologique,  xxiv,  p.  256),  who  an- 
alyzes Rousseau's  case  in  detail,  also  justly  calls  attention  to  its 
masochistic  significance,  when  he  says :  "  Ce  qu'aime  Rousseau 
dans  les  femmes,  ce  n'est  pas  seulement  le  sourcil  fronce,  la 
main  levee,  le  regard  severe,  l'attitude  imperieuse,*  c'est  aussi 
l'etat  emotionnel,  dont  ces  faits  sont  la  traduction  exterieure ; 
il  aime  la  femme  Here,  dedaigneuse,  l'ecrasant  a  ses  pieds  du 
poids  de  sa  royale  colere."2 

The  solution  of  this  enigmatical  psychological  fact  Binet 
finds  in  his  assumption  that  it  is  an  instance  of  fetichism,  only 
with  the  difference  that  the  object  of  the  fetichism — i.e.,  the 
object  of  individual  attraction  (fetich) — is  not  a  portion  of  the 
body,  like  a  hand  or  foot,  but  a  mental  peculiarity.  This 
enthusiasm  he  calls  "  amour  spiritualiste"  in  contrast  with 
"  amour  plastique"  as  manifested  in  ordinary  fetichism. 

This  deduction  is  acute,  but  it  gives  only  a  word  with 
which  to  designate  a  fact,  not  a  solution  of  it.  Whether  an 
explanation  is  possible  will  later  occupy  our  attention. 

There  were  also  elements  of  masochism  (and  sadism)  in  the 


1  "  Never  daring  to  express  my  desire,  I  at  least  gave  it  rein  under  circumstances 
that  served  to  preserve  in  me  the  idea  of  it." 

2  "  What  Rousseau  loves  in  women  is  not  only  the  frowning  hrow,  the  threatening 
hand,  the  angry  glance,  the  imperious  attitude,  but  it  is  also  the  emotional  state  of  which 
these  are  the  objective  translation  ;  he  loves  the  fierce,  disdainful  woman  who  crushes  him 
at  her  feet  with  the  weight  of  her  royal  displeasure." 


122  PSYCHOPATH!  A   SEXUALIS. 

celebrated,  or  notorious,  French  writer,  C.  P.  Baudelaire,  who 
died  insane. 

Baudelaire  came  of  an  insane  and  eccentric  family.  From  his  youth 
he  was  mentally  abnormal.  His  vita  sexualis  was  decidedly  abnormal. 
He  had  love-affairs  with  ugly,  repulsive  women, — negresses,  dwarfs, 
giantesses.  About  a  very  beautiful  woman, he  expressed  the  wish  to  see 
her  hung  up  by  her  hands,  and  to  kiss  her  feet.  This  enthusiasm  for  the 
naked  foot  also  appears  in  one  of  his  glowing  poems  as  the  equivalent  of 
sexual  indulgence.  He  said  women  were  animals  who  had  to  be  shut  up, 
beaten,  and  fed  well.  The  man  displaying  these  masochistic  and  sadistic 
inclinations  died  of  paretic  dementia.  (Lombroso,  "  The  Man  of 
Genius.") 

In  scientific  literature,  the  conditions  that  constitute  maso- 
chism have  not  received  attention  until  recently.  All  there  is 
to  mention  is  that  Tarnovvsky  ("  die  Krankhaften  Erscheinungen 
des  Geschlechtssinns,"  Berlin,  1886)  relates  that  he  has  known 
happily  married,  intellectual  men,  who  from  time  to  time  felt  an 
irresistible  impulse  to  subject  themselves  to  the  coarsest,  cynical 
treatment, — to  scoldings  or  blows  from  passive  or  active  peder- 
asts, or  prostitutes.  It  is  worthy  of  remark  that,  in  Tarnow- 
sky's  observation,  in  certain  cases  blows,  even  when  they  draw 
blood,  do  not  bring  the  result  desired  (virility,  or  at  least  ejac- 
ulation during  flagellation)  by  those  given  to  passive  flagel- 
lation. "  The  individual  must  then  be  undressed  by  force,  his 
hands  tied,  fastened  to  a  bench,  etc.,  during  which  he  fancies 
that  he  makes  opposition,  scolds,  and  pretends  to  resist.  Only 
under  such  circumstances  do  the  blows  induce  excitement  that 
leads  to  ejaculation." 

O.  Zimmermann's  work,  "  Die  Wonne  des  Leids,"  Leipzig, 
1885,  also  contributes  much  to  this  subject,1  taken  from  the 
history  and  literature. 

Of  late  the  subject  has  been  given  much  attention. 

1  However,  the  domain  of  masochism  must  he  sharply  differentiated  from  the  prin- 
cipal subject  of  that  work,  which  is,  that  love  contains  an  element  of  suffering.  Unre- 
quited love  has  always  been  described  as  "sweet,  but  sorrowful ;"  and  poets  have  spoken 
of  "blissful  pain"  or  "painful  bliss."  This  must  not,  as  it  is  by  Z.,  be  confounded  with, 
the  manifestations  of  masochism,  any  more  than  the  characterization  of  an  unyielding 
lover  as  "cruel"  should  be.  It  is  remarkable,  however,  that  Hamerling  ("  Amor  und 
Psyche,"  iv,  Gesang)  usee  perfect  masochistic  pictures,  flagellation,  etc.,  to  express  this 
feeling. 


MASOCHISM.  123 

A.  Moll,  in  his  work, "  Die  Contrare  Sexualempfindung,"  pp. 
133  and  141  et  seq.,  Berlin,  1891,  gives  a  number  of  cases  of  com- 
plete masochism  in  individuals  of  contrary  sexuality,  and  among 
them  the  case  of  a  man  suffering  with  contrary  sexual  instinct, 
who  sent  written  instructions,  containing  twenty  paragraphs,  to 
a  man  engaged  for  his  purpose,  who  was  to  treat  and  abuse  him 
like  a  slave. 

In  June,  1891,  Mr.  Dimitri  von  Stefanowsky,  Deputy  Gov- 
ernment Attorney  in  Jaroslaw,  Russia,  informed  me  that,  about 
three  years  before,  he  had  given  his  attention  to  the  perversion 
of  the  vita  sexualis,  designated  "  masochism  "  by  me,  and  called 
"  passivism  "  by  him  ;  that  a  year  and  a  half  previously  he  had 
prepared  a  paper  on  the  subject  for  Professor  von  Kowalewsky 
for  the  Russian  Archives  of  Psychiatry  ;  and  that  in  Novem- 
ber, 1888,  he  had  read  a  paper  on  this  subject,  considered  in 
its  legal  and  psychological  aspects,  before  the  Legal  Society  of 
Moscow  (printed  in  the  Juridischen  Boten,  the  organ  of  the 
society,  in  numbers  6  to  8). 

In  later  fiction  the  psycho-sexual  perversion  which  forms 
the  subject  of  this  study  has  been  treated  by  Sacher-Masoch, 
whose  writings,  already  frequently  alluded  to,  afford  typical 
pictures  of  the  perverse  mental  life  of  men  of  this  kind.  Many 
affected  with  this  perversion  refer  directly  to  the  writings  of 
Sacher-Masoch,  as  is  seen  from  the  foregoing  cases,  as  typical 
descriptions  of  their  own  psychical  condition. 

In  "  Nana,"  Zola  has  a  masochistic  scene,  and  likewise  in 
"  Eugene  Rougon."  The  latest  "  decadent "  literature  of 
France  and  Germany  is  also  largely  concerned  with  the  themes 
of  sadism  and  masochism.  According  to  von  Stefanowsky's 
statement,  the  modern  Russian  novel  frequently  treats  the  sub- 
ject ;  but  the  statements  of  the  writer  of  travels,  Johaun  Georg 
Forster  (1754-1794),  show  that  this  subject  also  played  a  role  in 
Russian  folk-songs. 

(b)  Foot-  and  Shoe-Fetichists — Larvated  Masochism. — Fol- 
lowing the  above-mentioned  group  of  "  symbolic  "  masochists, 
who  do  not  exactly  desire  abuse  by  women  as  the  means  of  ex- 
pression of  subjection,  but  all  kinds  of  silly  acts  that  can  be 


124  PSYCHOPATHIA    SEXUALIS. 

understood  only  through  an  acquaintance  with  the  masochistic 
circle  of  ideas,  comes  the  very  numerous  class  of  foot-  and  shoe- 
fetichists. 

By  fetichists  (v.  infra,  3)  I  understand  individuals  whose 
sexual  interest  is  confined  exclusively  to  parts  of  the  female  body, 
or  to  certain  portions  of  female  attire.  One  of  the  most  fre- 
quent forms  of  this  fetichism  is  that  in  which  the  female  foot  or 
shoe  is  the  fetich,  and  becomes  the  exclusive  object  of  sexual 
feeling  and  desire.  It  is  highly  probable,  and  shown  by  a  Cor- 
rect classification  of  the  observed  cases,  that  the  majority — and 
perhaps  all — of  the  cases  of  shoe-fetichism  rest  upon  a  basis  of 
more  or  less  conscious  masochistic  desire  for  self-humiliation. 

In  Hammond's  case  (Case  53)  the  satisfaction  of  a  maso- 
chist  was  found  in  being  trod  upon.  In  Cases  44  and  48, 
they  also  had  themselves  trod  upon ;  in  Case  51,  equus  eroticus, 
the  person  loved  a  woman's  foot,  etc.  In  the  majority  of  cases 
of  masochism,  the  act  of  being  trod  upon  with  feet  plays  a 
part1  as  an  easily  accessible  means  of  expressing  the  relation 
of  subjection. 

Of  the  numerous  established  cases  of  shoe-fetichism,  the 
following  one,  reported  by  Dr.  A.  Moll,  of  Berlin,  which  corre- 
sponds in  many  respects  with  Hammond's  case,  but  which  is 
described  in  more  detail  and  more  carefully  observed,  seems 
especially  suited  to  show  the  connection  between  masochism 
and  shoe-fetichism: — 

Case  60.  0.  L.,  aged  31,  book-keeper  in  a  city  of  Wurtemburg; 
comes  of  a  tainted  family. 

The  patient  is  a  large,  powerful  man,  of  ruddy  appearance.  In 
general  he  is  of  a  quiet  temperament,  but  may  become  very  violent  on 
occasion  ;  he  says  himself  that  he  is  quarrelsome  and  inclined  to  assert 
himself.  L.  is  of  a  kindly  disposition  and  generous;  easily  made  to 
weep.  At  school  he  passed  for  a  talented  pupil,  with  good  powers  of 
comprehension.  The  patient  at  times  has  congestion  of  the  head,  but  is 
otherwise  healthy,  except  that  he  is  much  depressed  and  melancholic  as 
a  result  of  his  sexual  perversion,  here  to  be  described. 

But  little  can  be  learned  of  any  hereditary  taint. 


1  The  desire  to  be  trod  upon  also  occurs  in  religious  enthusiasts  (comp.  Turgenjew, 
"  Sonderbare  Geschichten  "). 


MASOCHISM.  125 

The  following  facts  concerning  the  development  of  his  sexual  life 
are  gathered  from  the  patient's  own  statements  : — 

In  very  early  youth — in  fact,  when  he  was  eight  or  nine  years  old — 
L.  had  the  desire  to  lick  his  teacher's  boots  like  a  dog.  L.  thinks  it  pos- 
sible that  this  thought  was  excited  in  him  by  his  once  seeing  a  dog 
actually  do  this,  but  he  cannot  state  this  with  certainty ;  and  it  seems 
much  more  certain  to  the  patient  that  the  first  ideas  of  this  kind  came 
in  a  waking  state,  not  in  dreams. 

From  his  tenth  to  his  fourteenth  year  he  constantly  sought  to 
touch  the  shoes  of  his  fellow-pupils,  and  also  those  of  little  girls;  but 
for  this  purpose  he  always  chose  boys  who  had  wealthy  and  prominent 
parents.  One  of  these,  the  son  of  a  rich  landed  proprietor,  had  riding- 
boots;  in  the  boy's  absence  L.  took  these  in  his  hands,  struck  himself 
with  them,  and  pressed  them  against  his  face.  L.  did  the  same  thing  with 
the  elegant  boots  of  an  officer  of  dragoons. 

After  the  beginning  of  puberty  the  desire  was  transferred  exclusively 
to  the  boots  of  females.  Thus,  while  skating,  the  patient's  attention  was 
entirely  occupied  with  putting  on  and  taking  off  skates  for  ladies  ;  but  he 
always  chose  only  such  women  as  were  rich  and  prominent  socially,  wear- 
ing elegant  boots.  In  the  street  and  eveiywhere  L.  constantly  looked  for 
elegant  boots.  His  love  for  them  went  so  far  that  he  often  put  in  his 
purse,  and  even  in  his  mouth,  the  sand  and  mud  that  bore  their  imprints. 
As  a  boy  of  fourteen  L.  visited  brothels ;  and  he  often  visited  a  cafe 
chantant  solely  to  excite  himself  with  the  sight  of  elegant  boots  (low  shoes 
were  less  attractive).  In  his  school-books  and  on  the  walls  of  closets, 
L.  drew  boots.  In  the  theatre  he  saw  nothing  but  the  shoes  of  the  ladies. 
For  hours  at  a  time,  in  the  street  and  on  board  steam-boats,  L.  would  run 
after  ladies  wearing  elegant  boots  ;  and  he  thought  with  delight  of  how 
he  might  get  a  chance  to  touch  the  boots.  This  peculiar  love  for  boots 
remains  unchanged.  The  thought  to  have  himself  trod  upon  by  ladies  in 
their  boots,  or  to  kiss  the  boots,  gives  L.  the  most  intense  sensual  delight. 
Before  shoe-stores  he  will  stand  and  stand,  merely  to  look  at  the  boots. 
He  is  particularly  excited  by  their  elegance. 

The  patient  prefers  high  buttoned  or  laced  boots  with  high  heels; 
but  less  elegant  boots,  even  with  low  heels,  also  excite  him,  if  their  wearer 
is  a  wealthy,  distinguished,  and  proud  lady. 

At  the  age  of  twenty  L.  attempted  coitus ;  but,  "  in  spite  of  the 
greatest  efforts,"  as  he  believes,  he  was  not  successful.  During  the 
attempt  the  patient  had  no  thought  of  shoes ;  on  the  contraiy,  he  had 
first  sought  to  excite  himself  sexually  with  shoes,  and  he  asserts  that 
too  great  excitement  was  to  blame  for  his  want  of  success  in  coitus.  Up 
to  this  time,  being  thirty-one  years  old,  he  has  attempted  coitus  only  four 
or  five  times,  and  always  in  vain. 

On  one  occasion  the  patient,  already  much  to  be  pitied  on  account 
of  his  disease,  had  the  misfortune  to  contract  syphilis.     In  reply  to  the 


126  PSYCHOPATH  A   SEXUALIS. 

question  as  to  what  he  regarded  as  the  most  lustful  act,  the  patient  said  : 
M  It  is  my  greatest  delight  to  lie  naked  on  the  floor  and  have  myself  trod 
upon  by  girls  wearing  elegant  boots;  but,  of  course,  this  is  possible  only 
in  brothels."  Moreover,  according  to  the  patient's  statements,  these 
sexual  perversions  of  men  are  well  known  in  man}7  houses  of  prostitu- 
tion,— a  proof  that  these  are  not  so  very  infrequent.  The  prostitutes 
call  these  men  "  boot-lovers."  But  the  patient  has  only  veiy  infre- 
quently had  the  lustful  act  actually  performed,  notwithstanding  the  fact 
that  it  is  most  beautiful  and  pleasant  to  him.  The  patient  has  no 
thoughts  that  impel  to  intercourse ;  at  least,  not  in  the  sense  of  iin- 
missio  penis  in  vagina, — an  act  that  affords  him  no  pleasure  whatever. 
Indeed,  he  has  gradually  developed  a  fear  of  coitus,  which  may  be 
sufficiently  explained  by  his  numerous  unsuccessful  attempts ;  for  the 
patient  says  himself  that  his  inability  to  complete  coitus  embarrassed 
him  exceeding^.  The  patient  has  never  practiced  real  onanism.  With 
the  exception  of  a  few  occasions  on  which  the  patient  satisfied  his 
sexual  desire  by  onanism  with  boots  or  in  a  similar  way,  he  is  innocent 
of  such  satisfaction  ;  for,  in  the  excitement  with  boots,  there  is  scarcely 
ever  anything  more  than  erection ;  at  most,  only  a  slight  discharge  of 
fluid  takes  place  slowly,  which  the  patient  takes  to  be  semen. 

Simply  a  shoe,  worn  by  no  one,  excites  him  when  he  sees  it,  but 
not  nearly  as  intensely  as  when  it  is  worn  by  a  woman.  New  shoes  that 
have  not  been  worn  excite  him  much  less  than  those  thai  have  been 
used  ;  but  they  must  fiL^^e  from  wear  and  look  as  new  as  possible. 
Shoes  of  this  kind  excite  him  the  most.  As  has  been  said,  ladies'  boots 
excite  him  when  they  are  not  on  the  feet.  Under  such  circumstances, 
in  fancy,  L.  creates  a  lad}-  for  them ;  he  presses  them  to  his  lips  and  on 
his  penis.  He  would  "  die  with  delight "  if  a  proud,  respectable  lady 
were  to  tread  upon  him  with  her  shoes. 

Aside  from  the  previously  mentioned  characteristics  of  the  women 
(pride,  wealth,  social  prominence),  which,  in  connection  with  the  elegance 
of  the  boots,  constitute  an  especial  stimulus,  the  patient  is  by  no  means 
indifferent  to  the  physical  charms  of  the  female  sex.  He  is  enthusiastic 
about  beautiful  women  without  thinking  of  boots,  but  this  love  is  not 
directed  to  sexual  satisfaction.  The  bodily  charms  play  a  part  even  in 
connection  with  the  boots ;  a  homely  old  woman,  even  wearing  the  most 
elegant  boots,  cannot  affect  the  patient.  The  rest  of  the  attire  and  other 
circumstances  also  play  an  essential  role,  as  is  shown  by  the  fact  that 
elegant  boots  worn  by  proud,  distinguished  women  especially  excite  the 
patient.  A  common  servant-girl,  in  her  working-dress,  even  in  the  most 
elegant  shoes,  would  not  excite  him.  Men's  shoes  and  boots  no  longer 
affect  the  patient ;  and  he  never  in  the  slightest  degree  feels  himself 
attracted  to  men  sexually. 

Yet  the  patient  has  erections  very  easily.  When  he  takes  a  child 
in  his  lap,  when  he  pats  a  dog  or  horse  for  some  time,  when  he  travels 


MASOCHISM.  127 

on  the  cars,  or  when  he  rides, — erections  occur.  In  the  latter  case  he 
thinks  it  is  due  to  the  shaking.  He  has  erections  every  morning;  and 
he  can  induce  erection  in  a  very  short  time  by  thinking  of  the  act  with 
boots  that  is  so  pleasing  to  him.  Pollutions  formerly  occurred  fre- 
quently at  night — about  every  three  or  four  weeks ;  now  they  are  more 
infrequent,  occurring  once  about  every  three  months. 

In  his  erotic  dreams  the  patient  is  almost  always  sexually  excited 
by  the  same  thoughts  that  excite  him  in  the  waking  state.  For  some 
time  he  thinks  he  has  felt  ejaculation  during  erection ;  but  he  draws  this 
conclusion  only  from  feeling  a  little  moisture  at  the  end  of  the  penis. 
Books  touching  the  sphere  of  the  patient's  sexual  ideas  especially  excite 
him.  Thus,  in  reading  "  Venus  in  Furs,"1  by  Sacher-Masoch,  he  is  so 
excited  "that  the  semen  just  runs  away  from  him."  Moreover,  with 
L.,  this  kind  of  ejaculation,  while  reading,  is  a  decided  satisfaction  of 
his  sexual  desire.  My  question,  whether  blows  received  from  a  woman's 
hand  would  also  excite  him,  the  patient  thinks  he  would  have  to  answer 
in  the  affirmative.  The  patient  has  never  made  any  such  trial,  but  play- 
ful  taps  had,  at  any  rate,  alwaj'S  been  very  pleasing  to  him. 

It  would  afford  the  patient  a  particularly  intense  pleasure  if  he 
were  to  be  kicked  by  a  woman,  even  without  shoes,  and  with  bare  feet. 
He  does  not  think  that  the  blows,  as  such,  would  cause  the  excitement, 
but  rather  the  thought  of  being  maltreated  by  a  woman ;  and  this  might 
follow  scolding  as  well  as  actual  blows.  Besides,  blows  and  cross  words 
had  an  exciting  effect  only  when  they  came  from  a  proud  and  distin- 
guished lady.'  In  general  it  is  the  feeling  of  humiliation  and  slavish 
subjection  that  gives  the  patient  lustful  pleasure.  "  Were  a  lady,"  the 
patient  tells  me,  "  to  command  me  to  wait  on  her,  even  with  distant  cold- 
ness, I  should,  nevertheless,  feel  sensual  pleasure." 

To  the  question,  whether  with  boots  the  feeling  of  humiliation  came 
over  him,  the  patient  answers  :  "  I  think  that  this  general  passion  for  self- 
humiliation  has  been  concentrated  especially  on  ladies'  boots ;  for  it  is 
symbolic  of  one's  being  '  unworthy  to  loosen  the  latchet  of  another%s 
shoe';  and,  besides,  a  subject  kneels." 

Women's  stockings  also  have  an  exciting  effect  on  the  patient,  but 
only  to  a  slight  extent,  and  perhaps  only  through  awakening  an  idea  of 
boots.  The  patient's  passion  for  ladies'  boots  had  constantly  increased, 
but  of  late  years  he  thought  he  had  noticed  a  diminution  of  it.  He 
seldom  visits  public  women,  and  is  also  more  capable  of  self-restraint. 
Yet  this  passion  still  rules  him  absolutely,  and  every  other  pleasure  is 
spoiled  by  it.     A  pretty  female  boot  could  attract  his  glance  from  the 


1  In  this  story  the  writer  describes  a  man  whose  greatest  pleasure  lies  in  being 
treated  like  a  slave  by  a  beautiful  woman,  whom  he  loves.  Besides  numerous  scenes  in 
which  the  man  is  whipped  by  the  woman,  there  are  others  in  which  he  is  trod  upon  by  her. 
It  is  this  act  that  forms  the  principal  means  of  excitement  in  the  case  above  described. 


128  PSYCHOPATHIA   SEXUALIS. 

most  beautiful  landscape.  At  the  present  time  he  often  goes  about  at 
night  in  the  corridors  of  hotels,1  seeking  elegant  ladies'  shoes,  which  he 
kisses  and  presses  against  his  face  and  neck,  but  principally  against  his 
penis. 

The  patient,  who  is  very  well-to-do,  a  short  time  ago  went  volun- 
tarily to  Italy,  only  with  the  thought  of  becoming  the  servant  of  a  rich 
and  distinguished  lady  unacquainted  with  him ;  but  the  plan  failed.  The 
patient,  who  came  only  for  consultation,  has  not  yet  been  treated 
medically. 

The  foregoing  history  reaches  almost  to  the  present  time,  and  in  the 
interval  he  has  made  me  communications  by  letter  concerning  his  condi- 
tion. It  does  not  require  an  extensive  commentary.  It  seems  to  me  to 
be  one  of  the  best  cases  to  illustrate  the  relationship  between  shoe- 
fetichism  and  masochism,  as  set  forth  by  von  Krafft-Ebing.2  The  principal 
charm  for  the  patient,  as  he,  without  leading  questions,  always  em- 
phasizes, is  his  subjection  to  a  woman,  who,  in  pride  and  position,  must 
be  as  far  above  him  as  possible. 

Such  cases,  in  which,  within  ja  fully-developed  circle  of 
masochistic  ideas,  the  foot  and  the  shoe  or  boot  of  a  woman,  con- 
ceived as  a  means  of  humiliation,  have  become  the  objects  of 
especial  sexual  interest,  are  numerous.  Through  numerous  de- 
grees that  are  easily  discriminated,  they  form  the  demonstrable 
transition  to  other  cases  in  which  the  masochistic  inclinations 
retreat  more  and  more  to  the  background,  and  little  by  little  pass 
beyond  the  threshold  of  consciousness;  while  the  interest  in 
women's  shoes,  apparently  absolutely  inexplicable,  alone  remains 
in  consciousness.  The  latter  are  the  numerous  cases  of  shoe- 
fetichism.  These  very  frequent  cases  of  shoe-lovers,  which,  like 
all  cases  of  fetichism,  possess  forensic  interest  (theft  of  shoes), 
occupy  a  position  midway  between  masochism  and  fetichism. 
The  majority  or  all  may  be  looked  upon  as  instances  of  larvated 
masochism   (the  motive  remaining  unconscious)  in  which  the 


1  In  Continental  hotels  the  guests  are  accustomed  to  put  their  shoes  in  the  corridors 
at  night,  to  be  cleaned. 

2  However,  against  the  theory  that  foot-  and  shoe-  fetichism  is  a  manifestation  of 
(latent)  masochism,  Dr.  Moll  {op.  cit.,  p.  136)  raises  the  objection  that  it  is  still  unex- 
plained why  the  fetichist  so  often  prefers  boots  with  high  heels,  then  boots  and  shoes  of  a 
particular  kind — buttoned  or  laced.  To  this  objection  it  may  be  remarked  that,  in  the  first 
place,  the  high  heels  characterize  the  shoes  as  feminine ;  and,  in  the  second  place,  that  in 
spite  of  the  sexual  character  of  his  inclination,  the  fetichist  demands  all  kinds  of  aesthetic 
qualities  in  his  fetich  (comp.  Case  90). 


MASOCHISM.  129 

female  foot  or  shoe,  as  the  masochisms  fetich,  has  acquired  an 
independent  significance. 

Next  come  two  cases  in  which  the  female  shoe  possesses 
a  subordinate  interest,  but  in  which  unmistakable  masochistic 
desires  play  an  important  part  (comp.  Case  44) : — 

Case  61.  Mr.  X.  aged  25,  parents  healthy,  never  sick  before,  places 
the  following  autobiography  at  my  disposal :  "  I  began  to  practice  onanism 
at  the  age  of  ten,  without  ever  having  any  lustful  thoughts  during 
the  act.  Yet  at  that  time — I  am  sure  of  this — the  sight  and  touch  of 
girls'  elegant  boots  had  a  peculiar  charm  for  me ;  my  greatest  desire 
was  also  to  wear  such  shoes, — a  wish  that  was  occasionally  fulfilled  at  mas- 
querades. But  I  was  also  troubled  b}ra  very  different  thought:  My  ideal 
was  to  see  myself  in  a  position  of  humiliation  ;  I  would  gladly  have  been 
a  slave,  and  whipped  ;  in  short,  I  wished  to  receive  the  treatment  that  one 
finds  described  in  many  stories  of  slavery.  I  do  not  know  whether  the 
reading  of  such  stories  gave  rise  to  my  wish,  or  whether  it  arose  spon- 
taneously. 

"  Puberty  began  at  tire  age  of  thirteen  ;  with  the  occurrence  of  ejac- 
ulation lustful  pleasure  increased,  and  I  masturbated  more  frequently, 
often  two  or  three  times  a  day.  From  my  twelfth  to  my  sixteenth  year*, 
during  the  act  of  onanism,  I  always  had  the  idea  that  I  was  forced  to 
wear  girls'  boots.  The  sight  of  an  elegant  boot,  on  the  foot  of  a  girl 
at  all  pretty,  intoxicated  me ;  I  inhaled  the  odor  of  the  leather  with 
avidity.  In  order  to  smell  leather  during  the  act  of  onanism,  I  bought 
a  pair  of  leathern  cuffs,  which  I  smelled  while  I  masturbated.  My  en- 
thusiasm for  ladies'  leathern  shoes  remains  the  same  to-day  ;  only,  since 
my  seventeenth  year,  it  has  been  coupled  with  the  wish  to  become  a  se?*- 
vant,  to  blacken  shoes  for  distinguished  ladies,  to  put  on  and  take  off 
their  shoes  for  them,  etc. 

"  My  dreams  at  night  are  made  up  of  shoe-scenes :  either  I  stand 
before  the  show-window  of  a  shoe-store  regarding  the  elegant  ladies' 
shoes, — particularly  buttoned  shoes, — or  I  lie  at  a  lady's  feet  and  smell  and 
lick  her  shoes.  For  about  a  year  I  have  given  up  onanism  and  go  ad  . 
puellas ;  coitus  takes  place  through  intense  thought  of  ladies'  buttoned 
shoes  ;  or,  if  necessary,  I  take  the  shoe  of  the  puella  to  bed  with  me.  I 
have  never  suffered  from  my  former  onanism.  I  learn  easily,  have  a  good 
memory,  and  have  never  had  headache  in  my  life.  This  much  concerning 
myself. 

"  A  few  words  about  my  brother :  I  am  thoroughly  convinced  that 
he  is  also  a  shoe-fetichist.  Of  the  many  facts  that  demonstrate  this  to 
me,  it  is  only  necessary  to  mention  that  it  is  a  great  pleasure  for  him  to 
have  a  certain  cousin  (a  very  beautiful  girl)  tread  upon  him.  As  for  the 
rest,  I  might  undertake  to  tell  whether  a  man  who  stands  before  a  shoe- 


130  PSYCHOPATHIA   SEXUALIS. 

store,  and  regards  the  shoes  on  exhibition,  is  a  "  foot-lover  "  or  not.  This 
anomaly  is  uncommonly  frequent.  When  in  the  circle  of  m}1,  acquaint- 
ance I  turn  the  conversation  to  the  question  of  what  woman's  charm  is, 
I  very  frequently  hear  it  said  that  it  is  much  more  in  attire  than  in 
nudity ;  but  every  one  is  careful  not  to  reveal  his  especial  fetich.  I 
think  an  uncle  of  mine  is  also  a  shoe-fetichist." 

Case.  62.  Reported  by  Mantegazza  in  his  "  Anthropological  Stud- 
ies," 1886,  p  110.  X.,  American,  of  good  family ,  mentally  and  morally  well 
constituted ;  from  the  beginning  of  puberty  capable  of  being  excited  sex- 
ually only  by  a  woman's  shoe.  Her  body  and  naked  or  stockinged  foot 
made  no  impression  on  him  ;  but  the  foot,  when  covered  with  the  shoe,  or  a 
shoe  alone,  induced  erection  and  even  ejaculation.  Sight  alone  was  suf- 
ficient for  him  in  the  case  of  elegant  shoes, — i.e.,  shoes  of  black  leather, 
buttoning  up  the  side,  and  having  very  high  heels.  His  sexual  desire 
was  powerfully  excited  by  touching,  kissing,  or  drawing  on  such  shoes. 
His  enjoyment  was  increased  by  driving  nails  through  the  soles  so  that 
their  points  would  penetrate  his  feet  while  walking.  This  caused  him 
terrible  pain,  but  he  had  real  lustful  feeling  at  the  same  time.  His  greatest 
enjoyment  was  to  kneel  down  before  the  elegantly -clad  feet  of  ladies  and 
have  them  step  on  him.  If  the  wearer  were  an  ugly  woman,  the  shoes 
would  not  affect  him,  and  his  fancy  would  cool.  If  the  patient  had  shoes 
alone  at  his  disposal,  his  fancy  would  create  a  beautiful  woman  wearing 
them,  and  ejaculation  would  result.  His  nightly  dreams  were  of  the  shoes 
of  beautiful  women.  He  considered  the  exposure  of  ladies'  shoes  in  show- 
windows  immoral ;  while  talk  about  the  nature  of  woman  seemed  to  him 
harmless,  but  in  bad  taste.  X.  attempted  coitus  several  times  without 
success  ;  ejaculation  never  occurred. 

In  the  following  case  the  masochistic  element  is  also  plain 
enough,  as  is  also  the  sadistic  (comp.  "Torture  of  Animals," 
under  "  Sadism  ") : — 

Case  63.  A  young,  powerful  man,  aged  26.  Nothing  in  the  oppo- 
site sex  excites  his  sensual  feeling  except  elegant  shoes  on  the  feet  of  a 
handsome  woman,  especially  when  they  are  made  of  black  leather  and 
have  high  heels.  The  shoes  without  the  wearer  are  sufficient.  It  gives 
him  the  greatest  pleasure  to  see,  touch,  and  kiss  them.  The  feminine 
foot,  when  bare  or  covered  with  a  stocking,  has  no  effect  on  him.  Since 
childhood  he  has  had  a  weakness  for  ladies'  fine  shoes. 

X.  is  potent ;  during  the  sexual  act  the  female  must  be  elegantly 
dressed  and,  above  all,  have  on  pretty  shoes.  At  the  height  of  sensual 
excitement  cruel  thoughts  about  the  shoes  arise.  He  is  forced  to  think 
with  delight  of  the  death-agonies  of  the  animal  from  which  the  leather 
was  taken.  Sometimes  he  is  impelled  to  take  chickens  and  other  animals 
with  him  to  Phryne,  in  order  to  have  her  tread  on  them  with  her  pretty 


MASOCHISM.  131 

shoes  for  his  pleasure.  He  calls  this  "  sacrificing  to  the  feet  of  Venus." 
At  other  times  he  has  the  woman  walk  on  him  with  her  shoes  on,  the 
harder  the  better. 

Until  the  last  year  it  was  sufficient — since  he  did  not  take  the  slight- 
est sensual  pleasure  in  women — to  caress  ladies'  shoes  that  pleased  him, 
thus  attaining  ejaculation  and  complete  satisfaction  (Lombroso,  Archiv 
di  Psichiatria,  ix,  fascic.  iii.) 

The  following  case  reminds  one  of  the  third  of  this  series, 
on  account  of  the  interest  in  the  nails  of  the  shoes  (as  capable  of 
inflicting  pain) ;  and  of  the  fourth,  on  account  of  the  slight 
accompanying  sadistic  element ; — 

Case  64.  X.,  aged  34,  married  ;  of  neuropathic  parentage ;  suffered 
severely  from  convulsions  as  a  child  ;  remarkably  precocious,  but  one-sided 
in  development  (could  read  at  age  of  three)  ;  nervous  from  childhood.  At 
the  age  of  seven  he  manifested  an  inclination  to  handle  shoes,  especially 
the  nails  of  women's  shoes.  The  mere  sight,  but  still  more  the  touching, 
of  the  shoe-nails  and  counting  them,  gave  him  indescribable  pleasure. 

At  night  he  gave  himself  up  to  imagining  how  his  cousins  had 
their  measures  taken  for  shoes ;  how  he  nailed  horse-shoes  on  to  one  of 
them  or  cut  her  feet  off.  In  time  the  shoe-scenes  came  upon  him  during 
the  day,  and  involuntarily  induced  erection  and  ejaculation.  Frequently 
he  took  the  shoes  of  female  occupants  of  the  house ;  and  if  he  touched 
them  with  his  penis  he  had  an  ejaculation.  For  a  long  time,  when  a 
student,  it  was  possible  for  him  to  control  his  ideas  and  inclinations ;  but 
there  came  a  time  when  he  was  compelled  to  listen  to  female  footsteps  on 
the  pavements,  which,  like  the  sight  of  the  nail-marks  in  ladies'  shoes,  or 
the  sight  of  shoes  in  the  windows  of  the  shoe-shops,  always  gave  him  a 
feeling  of  lustful  pleasure.  He  married,  and  during  the  first  months  of 
his  married  life  was  free  from  these  desires. 

Gradually  he  became  hysteropathic  and  neurasthenic.  At  this  stage 
he  began  to  have  hysterical  attacks  when  the  shoemaker  spoke  to  him  of 
nails  in  ladies'  shoes  or  of  driving  nails  in  the  same.  The  reaction  was 
still  greater  if  he  chanced  to  see  a  pretty  lady  with  shoes  well  beset  with 
nails.  In  order  to  induce  ejaculation  it  was  only  necessary  for  him  to  cut 
soles  out  of  pasteboard  and  beset  them  with  nails  ;  or  he  would  buy  ladies' 
shoes,  have  them  beset  with  nails  in  the  store,  and  at  home  scrape  them 
on  the  ground,  and  finally  touch  the  end  of  his  penis  with  them.  More- 
over, lustful  shoe-visions  occurred  spontaneously,  in  which  he  satisfied 
himself  by  masturbation. 

X.  is  otherwise  intelligent,  skillful  in  his  calling,  but  powerless  in 
combating  his  perverse  inclinations.  He  presents  phimosis ;  penis  short, 
expanded  at  the  root,  and  incapable  of  complete  erection.     One  day  the 


132  PSYCHOPATHIA    SEXUALIS. 

patient  allowed  himself  to  masturbate  when  excited  by  the  sight  of  ladies' 
shoes  beset  with  nails  in  the  window  of  a  shoe-shop,  and  thus  became  a 
criminal.     (Blanche,  Archiv.  de  Neurologie,  1882,  Nr.  22.) 

Reference  may  be  made  here  to  a  case  of  contrary  sexual- 
ity, to  be  described  later,  in  which  the  principal  sexual  interest 
was  in  the  boots  of  male  servants.  The  desire  was  to  be  trod 
upon  by  them. 

Case  65.  (Dr.  Pascal,  "  Igiene  dell'  amore.")  X.,  merchant,  from 
time  to  time  (but  particularly  in  bad  weather)  had  the  following  desire : 
He  would  accost  some  prostitute  and  ask  her  to  go  to  a  shoe-shop  with 
him,  where  he  would  buy  her  the  handsomest  pair  of  shoes  of  patent 
leather,  under  the  condition  that  she  would  put  them  on  immediately. 
After  this  took  place,  she  had  to  go  about  in  the  street,  walking  in 
manure  and  mud  as  much  as  possible,  in  order  to  soil  the  shoes.  After 
this,  X.  would  lead  the  person  to  an  hotel,  and,  almost  before  they  had 
reached  a  room,  he  would  cast  himself  on  her  feet,  feeling  an  extraordi- 
nary pleasure  in  applying  his  lips  to  them.  When  he  had  cleansed  the 
shoes  in  this  manner,  he  paid  her  and  went  his  way. 

From  these  cases  it  may  be  plainly  seen  that  the  shoe  is  the 
fetich  of  the  masochist,  and  apparently  because  of  the  relation 
of  the  dressed  female  foot  to  the  idea  of  being  trod  upon  and 
other  acts  of  humiliation.  When,  therefore,  in  other  cases  of 
shoe-fetich  ism,  the  female  shoe  appears  alone  as  the  excitant 
of  sexual  desire,  one  is  justified  in  presuming  that  masochistic 
motives  have  remained  latent.  The  idea  of  being  trod  upon, 
etc.,  remains  in  the  depths  of  unconscious  life,  and  the  idea  of 
the  shoe  alone,  the  means  for  such  acts,  rises  into  consciousness. 
Cases  that  are  otherwise  wholly  inexplicable  are  thus  sufficiently 
explained.  Here  one  has  to  do  wTith  larvated  masochism  ;  and 
this  may  always  be  assumed  as  the  unconscious  motive,  when, 
as  occurs  not  exceptionally,  the  origin  of  the  fetichism,  from  an 
association  of  ideas  on  the  occasion  of  some  particular  event, 
can  be  proved,  as  in  Cases  87  and  88. 

Such  cases  of  desire  for  ladies'  shoes,  without  conscious 
motive  and  without  demonstrable  origin,  are  really  innumera- 
ble.1    Three  cases  are  here  given  as  examples : — 

1  There  is  apparently  a  connection  between  foot-fetichism  and  the  fact  that  certain 
persons  of  this  kind,  whom  coitus  does  not  satisfy,  or  who  are  unable  to  perform  it,  find  a 
substitute  for  it  in  tritus  membri  inter  pedes  mulieris. 


MASOCHISM.  133 

Case  66.  Minister,  aged  50.  From  time  to  time  he  goes  to  houses 
of  prostitution  and  asks  to  rent  a  room.  He  enters  it  with  a  girl.  Then 
he  lustfully  regards  her  shoes,  takes  one  off  and  kisses  and  bites  it. 
Finally,  he  puts  it  ad  genitalia  and  ejaculat  semen  semineque  ejaculato 
axillas  pectusque  terit ;  then  he  comes  out  of  his  sensual  ecstasy.  He 
begs  the  woman  to  allow  him  to  keep  the  shoe  for  a  few  days,  and  always, 
at  the  appointed  time,  returns  it  with  thanks  (Cantarano,  La  Psichiatria, 
v,  p.  205). 

Case  67.  Student,  Z.,  aged  23  ;  comes  of  a  tainted  family.  Sister 
was  insane ;  brother  suffered  with  hysteria  virilis.  The  patient,  peculiar 
from  childhood,  has  frequent  attacks  of  hypochondriacal  depression, 
taedium  vitas,  and  feels  that  he  is  persecuted.  In  a  consultation  on 
account  of  mental  trouble,  I  find  him  a  very  perverse,  hereditarily  pre- 
disposed man,  with  neurasthenic  and  hypochondriacal  symptoms.  A 
suspicion  of  masturbation  is  confirmed.  Patient  makes  interesting  dis- 
closures concerning  his  vita  sexualis.  At  the  age  of  ten  he  was  power- 
fully attracted  by  the  foot  of  one  of  his  comrades.  At  twelve  he  became 
an  enthusiast  for  ladies'  feet.  It  gave  him  a  delightful  sensation  to  revel 
in  the  sight  of  them.  At  fourteen  he  began  to  masturbate,  thinking,  at 
the  same  time,  of  the  beautiful  foot  of  a  lady.  From  this  time  on  he 
was  taken  with  the  feet  of  his  three-year-old  sister.  The  feet  of  other 
females  that  attracted  him  induced  sexual  excitement.  Only  women's 
feet — no  other  part  of  them — interested  him.  The  thought  of  sexual 
intercourse  with  women  excited  his  disgust.  He  had  never  attempted 
coitus.  After  his  twelfth  year  he  had  no  interest  in  the  feet  of  male 
individuals.  The  style  of  covering  of  the  female  foot  is  indifferent  to 
him ;  it  is  only  necessary  that  the  person  seem  to  be  sympathetic.  The 
thought  of  enjoying  the  feet  of  prostitutes  was  disgusting  to  him.  For 
years  he  had  been  in  loA'e  with  his  sister's  feet.  If  he  could  but  obtain 
her  shoes,  the  sight  of  them  powerfully  excited  his  sensuality.  Kissing 
or  embracing  his  sister  did  not  have  this  effect.  His  greatest  delight 
was  to  embrace  and  kiss  the  foot  of  a  sympathetic  woman,  when  ejacula- 
tion would  result  with  a  lively  pleasurable  sensation.  Often  he  was 
impelled  to  touch  his  genitals  with  one  of  his  sister's  shoes ;  but  he  had 
been  able,  thus  far,  to  master  this  impulse,  especially  for  the  reason  that 
for  two  years  (owing  to  progressive  irritable  weakness  of  the  genitals) 
the  simple  sight  of  the  foot  had  induced  ejaculation.  From  his  relatives 
it  is  ascertained  that  the  patient  has  a  silly  admiration  for  the  feet  of 
his  sister;'  so  that  she  avoids  him  and  seeks  to  hide  her  feet  from  him. 
The  patient  looks  upon  his  perverse  sexual  impulse  as  pathological,  and 
is  painfully  affected  by  the  fact  that  his  vile  fancy  has  for  its  object  his 
sister's  foot.  He  avoided  opportunity  as  much  as  he  could,  and  sought 
to  help  the  matter  by  masturbation  when,  as  in  dreams  accompanied  by 
pollution,  ladies'  feet  filled  his  imagination.  However,  when  the  impulse 
became  too  powerful  he  could  not  avoid  gaining  a  partial  sight  of  his 


134  PSTCHOPATHIA   SEXUALIS. 

sister's  foot.  Immediately  after  ejaculation  he  would  become  angry 
with  himself  at  having  been  weak  again.  His  partiality  for  his  sister's 
foot  had  cost  him  many  a  sleepless  night.  He  often  wondered  that  he 
could  still  love  his  sister.  Although  it  seemed  right  to  him  that  she 
should  conceal  her  feet  from  him,  yet  he  was  often  irritated  because 
the  concealment  caused  him  to  have  pollutions.  The  patient  gives 
assurances  of  being  moral  in  other  respects,  which  are  confirmed  by  his 
relatives. 

Case  68.  S.,  New  York,  is  accused  of  being  a  street-thief.  Numer- 
ous cases  of  insanity  in  his  ancestry ;  father,  brother,  and  sister  men- 
tally abnormal.  At  seven  years,  violent  cerebral  concussion  twice.  At 
thirteen,  struck  with  a  beam.  At  fourteen  S.  had  violent  attacks  of 
headache.  Accompanying  these  attacks,  or  immediately  after  them,  pecu- 
liar impulse  to  take  the  shoes  of  female  members  of  the  family — as  a 
rule,  those  belonging  to  one  member — and  hide  them  in  some  out-of-the- 
way  corner.  Taken  to  task,  he  would  lie,  or  declare  that  he  had  no 
memory  of  the  affair.  The  passion  for  shoes  was  unconquerable,  and 
made  its  appearance  every  three  or  four  months.  On  one  occasion  he 
attempted  to  take  the  shoe  from  the  foot  of  one  of  the  servants,  and  on 
another  he  stole  his  sister's  shoe  from  her  sleeping-apartment.  In  the 
spring  two  ladies  had  their  shoes  torn  from  their  feet  in  the  open  street. 
In  August  S.  left  his  home  early  in  the  morning  to  go  to  his  work  as  a 
printer.  A  moment  afterward  he  tore  the  shoe  from  a  girl's  foot  in 
the  open  street,  fled  to  his  place  of  work,  and  there  was  an-ested  as  a  street- 
thief.  He  declared  that  he  did  not  know  much  of  his  act ;  that  it  had 
come  upon  him  like  a  stroke  of  lightning,  at  the  sight  of  a  shoe,  that  he 
must  possess  himself  of  it,  but  for  what  purpose  he  did  not  know.  He 
had  acted  while  in  a  state  of  unconsciousness.  The  shoe,  as  he  correctly 
indicated,  was  found  in  his  coat.  In  confinement  he  was  so  much  excited 
mentally  that  an  outbreak  of  insanity  was  feared.  Discharged,  he  stole 
his  wife's  shoes  while  she  slept.  His  moral  character  and  habits  of  life 
were  blameless.  He  was  an  intelligent  workman ;  but  irregularity  of 
employment,  that  soon  followed,  made  him  confused  and  incapable  of 
work.  Pardoned.  (Nichols,  Am.  Journal  of  Insanity,  1859;  Beck, 
"  Med.  Jurisprudence,"  vol.  i,  p.  732,  1860.) 

Dr.  Pascal  (op.  eit.)  has  some  similar  cases,  and  many  others 
have  been  mentioned  to  me  by  colleagues  and  patients. 

(c)  Disgusting  Acts  for  the  Purpose  of  Self -Humiliation 
and  Sexual  Gratification  —  Larvated  Masochism. — There  are 
numerous  established  cases  in  which  perverted  men  are  thrown 
into  sexual  excitement  by  the  secretions,  or  even  the  excretions, 
of  women,  and  try  to  see  and  touch  them.  Probably  in  these 
cases  there  is  almost  always  an  unconscious  masochistic  impulse, 


MASOCHISM.  135 

— pleasure  in  the  most  extreme  humiliation  of  self,  and  desire 
to  experience  it. 

This  connection  is  made  perfectly  clear  by  the  confessions 
of  those  affected  with  this  repugnant  perversion.  Case  88  of 
the  sixth  edition — that  of  an  individual  affected  with  con- 
trary sexuality,  which  is  later  described — is  here  instructive. 
The  subject  of  this  case  not  only  revels  in  the  thought  of  being 
the  slave  of  the  beloved  man,  and  refers  on  this  point  to  Sacher- 
Masoch's  "Venus  in  Furs,"  sed  etiam  sibi  fingit  amatum  pos- 
cere  ut  crepidas  sudore  diffluentes  olfaciat  ejusque  stercore 
vescatur.  Deinde  narrat,  quia  non  habeat,  quae  confingat  et 
exoptet,  eorum  loco  suas  crepidas  sudore  infectas  olfacere  suoque 
stercore  vesci,  inter  quae  facta  pene  errecto  se  voluptate  pertur- 
bari  semenque  ejaculari. 

The  masochistic  significance  of  a  disgusting  act  in  the  follow- 
ing case,  communicated  by  a  professional  friend,  is  clear : — 

Case  69.  H.  v.  G.,  landed  proprietor ;  major ;  died  in  his  sixtieth 
year;  came  of  a  family  in  which  irresponsibility, tendency  to  run  in  debt, 
and  defect  of  morals  are  hereditary.  In  his  youth  he  was  given  to  most 
reckless  dissipation  (he  was  known  as  the  leader  of  "  naked  balls  ").  He 
was  always  of  a  cynical  and  brutal  nature,  though  punctilious  and  exact 
in  his  military  service,  which,  on  account  of  a  disreputable  affair  that 
was  not  made  known,  he  had  to  leave,  and  he  lived  in  private  life  seven- 
teen years.  Untrammeled  by  the  necessity  to  earn  his  living,  he  led  every- 
where the  life  of  a  man-of-the-town,  and  was  everywhere  avoided  on 
account  of  his  lascivious  nature.  His  ostracism  by  the  best  society, 
which,  in  spite  of  his  independence,  he  noticed,  caused  him  to  prefer  the 
ordinary  society  of  fakirs,  artisans,  and  loafers.  It  cannot  be  ascertained" 
that  he  had  sexual  intercourse  with  men,  but  it  is  certain  that  in  his 
later  years  he  arranged  symposiums  with  mixed  company  and  was  known 
as  a  roue.  In  the  last  few  years  of  his  life  he  was  accustomed  to  hang 
about  new  buildings  in  the  evening,  and  of  the  women  working  there  he 
would  ask  the  dirtiest  to  accompany  him.  It  is  certain  that  he  had  the 
woman  undress,  and  then  he  would  suck  her  toes,  his  libido  being  ex- 
cited and  satisfied  by  the  act. 

Cantarano  also  reports  a  case  in  La  Psichiatria,  v  year,  p. 
207,  in  which,  preceding  the  act,  apparently  from  a  similar 
cause,  there  was  biting  and  sucking  of  a  woman's  toes  in  as 
filthy  a  state  as  possible. 


136  PSYCHOPATHIA   SEXUALIS. 

Several  cases  have  come  to  my  knowledge  in  which,  with 
other  masochistic  acts  (maltreatment,  humiliation),  such  disgust- 
ing desires  were  entertained ;  and  the  confessions  of  the  indi- 
viduals left  no  doubt  of  their  significance. 

Such  cases  prepare  the  way  to  an  understanding  of  others 
which  are  absolutely  incomprehensible  without  the  connection 
with  the  masochistic  desire  for  humiliation.1  It  is  probable,  how- 
ever, that  this  impulse,  in  its  actual  significance,  remains  unknown 
to  the  perverted  individual,  and  only  the  desire  for  disgusting 
things  rises  into  consciousness, — again  larvated  masochism. 

Other  cases  of  Cantarano's  (loc.  cit.)  belong  here :  mictio 
even  defaecatio  puellse  ad  linguam  viri  ante  actum ;  consumption 
of  confects  smelling  like  faeces,  in  order  to  become  potent ;  and 
also  the  following  case,  likewise  communicated  to  me  by  a 
physician : — 

Case  TO.  A  Russian  prince,  who  was  very  decrepit,  was  accustomed 
to  have  his  mistress  turn  her  back  to  him  and  defecate  on  his  breast ;  this 
being  the  only  way  in  which  he  could  excite  the  remnant  of  libido. 

Another  supported  a  mistress  in  unusually  brilliant  style,  with  the 
condition  that  she  eat  marchpane  exclusively.  Ut  libidinosus  fiat  et  ejac- 
ulare  possit  excrementa  feminae  ore  exciprt.  A  Brazilian  physician  tells 
me  of  several  cases  of  defaecatio  feminae  in  os  viri  that  have  come  to  his 
knowledge.  Such  cases  occur  everywhere,  and  are  not  at  all  infrequent. 
All  kinds  of  secretions — saliva,  nasal  mucus,  and  even  aural  cerumen 
— are  used  in  this  way  and  swallowed  with  pleasure ;  and  oscula  ad 
nates  and  even  ad  anum  are  indulged  in.  Dr.  Moll  (op.  cit.,  p.  135) 
reports  the  same  thing  of  a  man  affected  with  contrary  sexuality.  The 
perverse  desire  to  practice  cunnilingus,  which  is  very  wide-spread,  proba- 
bly frequently  has  its  root  in  masochistic  impulses. 

Palanda  (Archivio  di  PsicJiiatria.  x,  fascicolo  3,  4)  relates 
the  following  case: — 

Case  71.  W.,  aged  45,  predisposed,  was  given  to  masturbation  at 
the  age  of  eight.  A  decimo  sexto  anno  libidines  suas  bibendo  recentem 
feminarum  urinam  satiavit.  Tanta  erat  voluptas  urinam  bibentis  ut  nee 
aliquid  olfaceret  nee  saperet,  haec  faciens.     After  drinking  he  always 

1  Analogy  with  the  excesses  of  religious  enthusiasm  is  found  even  here.  The  religi- 
ous enthusiast,  Antoinette  Bouvignon  de  la  Porte,  mixed  her  food  with  fseces  to  punish  her- 
self (Zimmermann,  op.  cit.,  p.  124).  The  beatified  Marie  Alacoque,  to  "  mortify  "  herself, 
licked  up  with  her  tongue  the  dejections  of  patients,  and  sucked  their  toes  covered  with 
6ores. 


MASOCHISM.  137 

experienced  disgust  and  ill-feeling,  and  made  firm  resolutions  to  do  it  no 
more  in  the  future.  Once  he  had  the  same  pleasure  in  drinking  the  urine 
of  a  nine-year-old  boy,  with  whom  he  once  practiced  fellatio.  The  patient 
suffers  with  epileptic  insanity. 

The  cases  described  in  this  group  form  the  complete  coun- 
terpart to  group  "  d  "  of  the  sadists. 

Still  other  older  cases  belong  here,  which  Tardicu  ("  fitude  me'dico- 
legale  sur  les  attentats  aux  mceurs,"  p.  206)  observed  in  senile  individuals. 
He  describes  as  "  Renifleurs  "  persons  "  qui  in  secretos  locos  nimirum 
theatrorum  pasticos  convenientes  quo  complures  feminae  ad  micturi- 
endum  festinant,  per  nares  urinali  odore  excitati,  illico  se  invicem  pol- 
luunt."  The  "  Stercoraires "  that  Taxil  ("  La  prostitution  contem- 
poraine")  mentions  are,  in  relation  to  this  subject,  unique. 

Finally,  space  is  here  given  to  the  following  case,  reported 
to  me  by  a  physician : — 

Case  72.  A  notary,  known  from  his  youth  to  those  about  him  as 
peculiar  and  misanthropic.  During  his  school-days  he  was  given  to 
masturbation.  According  to  his  own  story,  he  excited  his  sexual  desire 
by  spreading  out  on  the  cover  of  his  bed  pieces  of  toilet-paper  that  he 
had  used,  induced  erection  by  regarding  and  smelling  them,  and  then 
practiced  masturbation.  After  his  death,  by  the  side  of  his  bed,  there 
was  found  a  large  basket  of  such  papers,  with  the  dates  marked  on  them. 
Here  there  were  probably  fancies  of  the  nature  of  the  above-mentioned  acts. 

(d)  Masochism  in  Women. — In  woman  voluntary  subjection 
to  the  opposite  sex  is  a  physiological  phenomenon.  Owing  to 
her  passive  role  in  procreation  and  long-existent  social  condi- 
tions, ideas  of  subjection  are,  in  woman,  normally  connected 
with  the  idea  of  sexual  relations.  So  to  speak,  they  form  the 
harmonics  which  determine  the  tone-quality  of  feminine  feeling. 

Any  one  conversant  with  the  history  of  civilization  knows 
in  what  a  state  of  absolute  subjection  woman  was  always  kept 
until  a  relatively  high  degree  of  civilization  was  reached  ;*  and 
an  attentive  observer  of  life  may  still  easily  recognize  how  the 
custom   of  unnumbered  generations,  in    connection  with    the 

1  The  laws  of  the  early  Middle  Ages  gave  the  husband  the  right  to  kill  the  wife  ; 
those  of  the  later  Middle  Ages,  the  right  to  beat  her.  The  latter  right  was  used  freely, 
even  by  those  of  high  standing  (comp.  Schultze,  Das  hdfische  Leben  zur  zeit  des  Min- 
nesangs,  Bd.  i,  p.  163  et  seq.).  Yet,  by  the  side  of  this,  the  paradoxical  chivalry  of  the 
Middle  Ages  stands  unexplained. 


138  PSYCHOPATHIA   SEXUALIS. 

passive  role  with  which  woman  has  been  endowed  by  Nature, 
has  given  her  an  instinctive  inclination  to  voluntary  subordina- 
tion to  man ;  he  will  notice  that  exaggeration  of  customary 
gallantry  is.  very  distasteful  to  women,  and  that  a  deviation 
from  it  in  the  direction  of  masterful  behavior,  though  loudly 
reprehended,  is  often  accepted  with  secret  satisfaction.1  Under 
the  veneer  of  polite  society  the  instinct  of  feminine  servitude  is 
everywhere  discernible. 

Thus  it  is  easy  to  regard  masochism  in  general  as  a  patho- 
logical growth  of  specific  feminine  mental  elements, — as  an 
abnormal  intensification  of  certain  features  of  the  psycho-sexual 
character  of  woman, — and  to  seek  its  primary  origin  in  that 
sex  (v.  infra,  p.  145).  It  may,  however,  be  held  to  be  estab- 
lished that,  in  woman,  an  inclination  to  subordination  to  man 
(which  may  be  regarded  as  an  acquired,  purposeful  arrange- 
ment, a  phenomenon  of  adaptation  to  social  requirements)  is  to 
a  certain  extent  a  normal  manifestation. 

The  reason  that,  under  such  circumstances,  the  "  poetry  " 
of  the  symbolic  act  of  subjection  is  not  reached,  lies  partly  in 
the  fact  that  man  has  not  the  vanity  of  that  weakling  who 
would  use  blows  to  display  his  power  (as  the  love-serving 
knights  did  with  the  ladies  of  the  Middle  Ages),  but  prefers 
to  demonstrate  his  real  advantages.  The  barbarian  has  his  wife 
plow  for  him,  and  the  civilized  lover  speculates  about  her  dowry ; 
she  willingly  endures  both. 

Cases  of  pathological  increase  of  this  instinct  of  subjection,  in 
the  sense  of  feminine  masochism,  are  probably  frequent  enough, 
but  custom  represses  their  manifestation.  Many  young  women 
like  nothing  better  than  to  kneel  before  their  husbands  or  lovers. 
Among  all  Slavs  of  the  lower  classes  it  is  said  that  the  wives 
feel  hurt  if  they  are  not  beaten  by  their  husbands.  A  Hunga- 
rian officer  informs  me  that  peasant  women  of  the  Somogy'er 
Comitates  do  not  think  they  are  loved  by  their  husbands  until 
they  have  received  the  first  box  on  the  ear  .as  a  sign  of  love. 


1  Comp.  Lady  Milford's  words  in  Schiller's  "  Kabale  und  Liebe  " :  "We  women 
can  only  choose  between  ruling  and  serving ;  but  the  highest  pleasure  power  affords  is  but 
a  miserable  substitute,  if  the  greater  joy  of  being  the  slaves  of  a  man  we  love  is  denied  us!" 


MASOCHISM.  139 

It  would  probably  be  difficult  for  tbe  pliysician  to  find 
cases  of  feminine  masochism.  Subjective  and  objective  re- 
straints— modesty  and  custom — naturally  constitute,  in  women, 
insurmountable  obstacles  to  the  expression  of  perverse  sexual 
instinct.  Thus  it  happens  that,  up  to  the  present  time,  but  one 
case  of  masochism  in  a  woman  has  been  scientifically  estab- 
lished ;  and  this  is  accompanied  by  circumstances  that  obscure  it. 

Case  73.  Miss  v.  X.,  Russian,  aged  35 ;  of  greatly  predisposed  family. 
For  some  years  she  has  been  in  the  initial  stage  of  paranoia  persecutoria. 
This  sprang  from  cerebro-spinal  neurasthenia,  the  origin  of  which  is  found 
to  be  sexual  hyper-excitation.  Since  her  twenty-fourth  year  she  has  been 
given  to  masturbation.  As  a  result  of  disappointment  in  an  engagement 
and  intense  sexual  excitement,  she  began  to  practice  masturbation  and  psy- 
chical onanism.  Inclination  toward  persons  of  her  own  sex  never  occurred. 
The  patient  says :  "  At  the  age  of  six  or  eight  I  conceived  a  desire  to  be 
whipped.  Since  I  had  never  been  whipped,  and  had  never  been  present 
when  others  were  thus  punished,  I  cannot  understand  how  I  came  to 
have  this  strange  desire.  I  can  only  think  that  it  is  congenital.  With 
these  ideas  of  being  whipped  I  had  a  feeling  of  actual  delight,  and  pict- 
ured in  my  fancy  how  fine  it  would  be  to  be  whipped  by  one  of  my 
female  friends.  I  never  had  any  thought  of  being  whipped  by  a  man.  I 
reveled  in  the  idea,  and  never  attempted  any  actual  realization  of  my 
fancies.  These  disappeared  after  my  tenth  year.  Only  when  I  read 
"  Rousseau's  Confessions,"  at  the  age  of  thirty-four,  did  I  understand 
what  my  longing  for  whippings  meant,  and  that  my  abnormal  ideas  were 
like  those  of  Rousseau.  Since  my  tenth  year  I  have  never  had  any 
more  such  fancies." 

On  account  of  its  original  character  and  the  reference  to 
Rousseau,  this  case  may  with  certainty  be  called  a  case  of 
masochism.  The  fact  that  it  is  a  female  friend  that  is  conceived 
in  imagination  as  whipping  her,  is  explained  by  the  circum- 
stance that  the  masochistic  desire  was  here  present  in  the  mind 
of  a  child  before  the  psychical  vita  sexualis  had  developed  and 
the  instinct  for  the  male  had  been  awakened.  Contrary  sexual 
instinct  is  here  expressly  excluded. 


An  Attempt  to  Explain  Masochism. 

The  facts  of  masochism  are  certainly  among  the  most  in- 
teresting in  the  domain  of  psychopathology.      An  attempt  to 


140  PSYCHOPATH!  A   SEXUALIS. 

explain  them  must  first  seek  to  distinguish  in  them  the  essential 
from  the  unessential.  The  distinguishing  characteristic  in  maso- 
chism is  certainly  the  unlimited  subjection  to  the  will  of  a  person 
of  the  opposite  sex  (in  sadism,  on  the  contrary,  the  unlimited 
mastery  of  this  person),  with  the  awakening  and  accompani- 
ment of  lustful  sexual  feelings  to  the  degree  of  orgasm.  From 
all  that  has  preceded  it  is  clear  that  the  particular  manner  in 
which  this  relation  of  subjection  or  domination  is  expressed  (v. 
supra),  whether  in  simply  symbolic  acts,  or  whether  there  is 
also  a  desire  to  suffer  pain  at  theJiands  of  a  person  of  the  opposite 
sex,  is  a  subordinate  matter.  V 

While  sadism  may  be  locked  upon  as  a  pathological  inten- 
sification of  the  masculine  sexual  character  in  its  psychical 
peculiarities,  masochism  rather  represents  a  pathological  degen- 
eration of  the  distinctive  psychical  peculiarities  of  woman.  But 
masculine  masochism  is  undoubtedly  frequent ;  and  it  is  this  that 
most  frequently  comes  under  observation  and  almost  exclusively 
makes  up  the  series  of  observed  cases.  The  reason  for  this  has 
been  previously  stated  (p.  139). 

Two  sources  of  masochism  can  be  distinguished  in  the 
sphere  of  normal  phenomena.  The  first  is,  that  in  the  state 
of  lustful  excitement  every  impression  made  by  the  person 
giving  rise  to  the  sexual  stimulus,  independently  of  the  nature 
of  its  action,  is  pleasing  to  the  individual  excited. 

It  is  entirely  physiological  that  playful  taps  and  light  blows 
should  be  taken  for  caresses, 

"Like  the  lover's  pinch  which  hurts  and  is  desired."1 

From  here  the  step  is  not  long  to  a  state  where  the  wish  to  experi- 
ence a  very  intense  impression  at  the  hands  of  the  consort  leads 
to  a  desire  for  blows,  etc.,  in  cases  of  pathological  intensification 
of  lust ;  for  pain  is  always  a  ready  means  for  producing  an  intense 
bodily  impression.  Just  as  in  sadism  the  sexual  emotion  leads 
to  a  state  of  exaltation  in  which  the  excessive  motor  excitement 
implicates  neighboring  nervous  tracts;  so  in  masochism  an 
ecstatic  state  arises,  in  which  the  rising  flood  of  a  single  emotion 

1  Anthony  and  Cleopatra,  v.  2. 


MASOCHISM.  141 

ravenously  devours  and  covers  with  lust  every  impression  coming 
from  the  beloved  person. 

The  second  and,  indeed,  the  most  important  source  of 
masochism  is  to  be  sought  in  a  wide-spread  phenomenon,  which, 
though  it  is  extraordinary  and  abnormal,  by  no  means  lies 
within  the  domain  of  sexual  perversion. 

I  here  refer  to  the  very  prevalent  fact  that  in  innumerable 
instances,  which  occur  in  all  varieties,  one  individual  becomes 
dependent  on  another  of  the  opposite  sex,  in  a  very  extraordi- 
nary and  remarkable  manner, — even  to  the  loss  of  all  independ- 
ent will ;  a  dependence  which  forces  the  party  in  subjection  to 
acts  and  suffering  which  greatly  prejudice  personal  interest,  and 
often  enough  to  offense  against  both  morality  and  law. 

This  dependence,  however,  differs  from  the  manifestations 
of  normal  life  only  in  the  intensity  of  the  sexual  feeling  that 
here  comes  in  play,  and  in  the  slight  degree  of  will-power  neces- 
sary for  the  maintenance  of  its  equilibrium.  The  difference  is 
one  of  intensity,  not  of  quality,  as  in  masochistic  manifestations. 

This  dependence  of  one  person  upon  another  of  the  oppo- 
site sex,  that  is  abnormal  but  not  perverse, — a  phenomena  pos- 
sessing great  interest  when  regarded  from  a  forensic  stand-point, 
— I  designate  "  sexual  bondage  ;" 1  for  the  relations  and  circum- 
stances attending  it  have  in  all  respects  the  character  of  bondage. 
The  will  of  the  ruling  individual  dominates  that  of  the  person 
in  subjection,  just  as  a  master's  does  his  bondsman's.2 

This  "  sexual  bondage,"  as  has  been  said,  is  certainly  an 
abnormal  phenomenon.  It  begins  with  the  first  deviation  from 
the  normal.  The  degree  of  dependence  of  one  person  upon 
another,  or  of  two  upon  each  other,  resulting  from  individual 
peculiarity  in  the  intensity  of  motives  that  in  themselves  are 

1  Comp.  the  author's  article,  "  iiber  geschlechtliche  Horigkeit  und  Masochismus," 
in  the  Psychiatrischen  Jahrbucher,  Bd.  x,  p.  169  et  seq.,  where  this  subject  is  treated  in 
detail,  and  particularly  from  the  forensic  stand-point. 

2  The  expressions  "slave"  and  "slavery,"  though  often  used  metaphorically  under 
such  circumstances,  are  avoided  here  because  they  are  the  favorite  expressions  of  maso- 
chism, from  which  this  "  bondage"  must  be  strictly  differentiated. 

The  expression  "bondage"  is  not  to  be  construed  to  mean  J.  S.  Mill's  "Bondage 
of  Woman."  What  Mill  designates  with  this  expression  are  laws  and  customs,  social  and 
historical  facts.  Here,  however,  we  always  speak  of  facts  having  peculiar  individual 
motives  that  even  conflict  with  prevalent  customs  and  laws. 


142  PSYCHOPATHIA   SEXUALIS. 

normal,  constitutes  the  normal  standard  established  by  law  and 
custom.  Sexual  bondage  is  not  a  perverse  manifestation,  how- 
ever; the  instinctive  activities  at  work  here  are  the  same  as 
those  that  set  in  motion — even  though  it  be  with  less  violence 
— the  psychical  vita  sexualis  which  moves  entirely  within  normal 
limits. 

Fear  of  losing  the  companion  and  the  desire  to  keep  him 
always  satisfied,  amiable,  and  inclined  to  sexual  intercourse,  are 
here  the  motives  of  the  individual  in  subjection.  An  extraor- 
dinary degree  of  love — which,  particularly  in  woman,  does  not 
always  indicate  an  unusual  degree  of  sensuality — and  a  weak 
character  are  the  simple  elements  of  this  extraordinary  process.1 

The  motive  of  the  dominant  individual  is  egoism,  which 
finds  unlimited  room  for  action. 

The  manifestations  of  sexual  bondage  are  various  in  form, 
and  the  cases  are  very  numerous.2  At  every  step  in  life  we  find 
men  that  have  fallen  into  sexual  bondage.  Among  married 
men,  hen-pecked  husbands  belong  to  this  category,  particu- 
larly elderly  men  who  marry  young  wives  and  try  to  overcome 
the  disparity  of  years  and  physical  defects  by  unconditional 
submission  to  the  wife's  every  whim ;  and  unmarried  men  of 
ripe  maturity,  who  seek  to  better  their  last  chance  of  love  by 
unlimited  sacrifice,  are  also  to  be  enumerated  here.  Here 
belong,  also,  men  of  any  age,  who,  seized  by  hot  passion  for  a 
woman,  meet  coldness  and  calculation,  and  have  to  capitulate 
on  hard  conditions;  men  of  loving  natures  who  allow  them- 
selves to  be  persuaded  to  marriage  by  notorious  prostitutes ; 
men  who,  to   run    after  adventuresses,  leave   everything   and 

1  Perhaps  the  most  important  element  is,  that  by  the  habit  of  submission  a  kind  of 
mechanical  obedience,  without  consciousness  of  its  motives,  which  operates  with  automatic 
certainty,  may  be  established,  having  no  opposing  motives  to  contend  with,  because  it  lies 
beyond  the  threshold  of  consciousness ;  and  it  may  be  used  by  the  dominant  individual 
like  an  inanimate  instrument. 

2  Sexual  bondage,  of  course,  plays  a  role  in  all  literatures.  Indeed,  for  the  poet,  the 
extraordinary  manifestations  of  the  sexual  life  that  are  not  perverse  form  a  rich  and  open 
field.  The  most  celebrated  description  of  masculine  "  bondage  "  is  that  by  Abbe  Prevost, 
"Mano  Lescault."  An  excellent  description  of  feminine  "bondage"  is  that  of  "Leone 
Leoni,"  by  George  Sand.  But  first  of  all  comes  Kleist's  "  Kathchen  von  Heilbronn,"  who 
himself  called  it  the  counterpart  of  (sadistic)  "  Penthesilea,"  Halm's  "  (Jriseldis  "  and 
many  other  similar  poems  also  belong  here, 


MASOCHISM.  143 

jeopardise  their  future ;  husbands  and  fathers  who  leave  wife 
and  child,  to  lay  the  income  of  a  family  at  the  feet  of  a  harlot. 

But,  numerous  as  the  examples  of  masculine  "  bondage  " 
are,  every  observer  of  life,  who  is  at  all  unprejudiced,  must 
allow  that  they  are  far  from  equalling,  in  number  and  impor- 
tance, the  cases  of  feminine  "  bondage."  This  is  easily  ex- 
plained. For  a  man,  love  is  almost  always  only  an  episode, 
and  he  has  many  other  and  important  interests ;  for  a  woman, 
on  the  other  hand,  love  is  the  principal  thing  in  life,  and,  until 
the  birth  of  children,  always  her  first  interest.  After  this  it  is 
still  often  her  first  thought,  but  always,  at  least,  takes  the 
second  place.  But,  what  is  still  more  important,  the  man  ruled 
by  this  impulse  easily  satisfies  it  in  embraces  for  which  he  finds 
unlimited  opportunities.  A  woman  in  the  upper  classes  of 
society,  if  she  have  a  husband,  is  bound  to  him  alone;  and 
even  in  the  lower  classes  there  are  still  great  obstacles  to  poly- 
andry. Therefore,  a  woman's  husband  means  for  her  the  whole 
sesc,  and  his  importance  to  her  becomes  very  great.  It  must 
also  be  considered  that  the  normal  relation  established  by  law 
and  custom  between  husband  and  wife  is  far  from  being  one  of 
equality.  In  itself  it  expresses  a  sufficient  predominance  of 
woman's  dependence.  The  concessions  she  makes  to  her  lover, 
to  retain  the  love  which  it  would  be  almost  impossible  for  her  to 
replace,  only  plunge  her  deeper  in  bondage ;  and  this  increases 
the  insatiable  demands  of  husbands  resolved  to  use  their  advan- 
tage and  traffic  in  woman's  readiness  to  sacrifice  herself,  v' 

Here  may  be  placed  the  fortune-hunter,  who  for  money 
allows  himself  to  be  enveloped  in  the  easily  created  illusions  of 
a  maiden ;  the  seducer,  and  the  man  who  compromises  wives, 
calculating  on  blackmail ;  the  gilded  army  officer  and  the 
musician  with  the  lion's  mane,  who  know  so  well  how  to 
stammer  "  Thee  or  death ! "  as  a  means  to  pay  debts  and 
provide  a  life  of  ease.  Here,  too,  belong  the  kitchen-soldier, 
whose  love  the  cook  returns  with  love  plus  means  to  satisfy  a 
different  appetite ;  the  drinker,  who  consumes  the  savings  of 
the  mistress  he  marries;  and  the  man  who  with  blows  compels 
the  prostitute  on  whom  he  lives  to  earn  a  certain  sum  for  him 


144  PSYCHOPATHIA   SEXUALIS. 

daily.  These  are  only  a  few  of  the  innumerable  forms  of  bond- 
age into  which  woman  is  forced  by  her  greater  need  of  love  and 
the  difficulties  of  her  position. 

The  subject  of  "  sexual  bondage  "  must  here  receive  brief 
consideration ;  for  in  it  may  be  clearly  seen  the  soil  from  which 
the  main  root  of  masochism  springs.  The  relationship  of  these 
two  phenomena  of  psychical  sexual  life  is  immediately  apparent. 
Bondage  and  masochism  both  consist  of  the  unconditional  sub- 
jection of  the  individual  affected  with  the  abnormality  to  a 
person  of  the  opposite  sex,  and  of  domination  of  the  former  by 
the  latter.1  The  two  phenomena,  however,  must  be  strictly 
differentiated ;  they  are  not  different  in  degree,  but  in  quality. 

Sexual  bondage  is  not  a  perversion  and  not  pathological ; 
the  elements  from  which  it  arises — love  and  weakness  of  will — 
are  not  perverse ;  it  is  only  their  simultaneous  activity  that  pro- 
duces the  abnormal  result  which  is  so  opposed  to  self-interest, 
and  often  to  custom  and  law.  The  motive,  in  obedience  to 
which  the  subordinated  individual  acts  and  endures  tyranny,  is 
the  normal  instinct  toward  woman  (or  man) ;  the  satisfaction  of 
which  is  the  price  of  bondage.  The  acts  of  the  person  in  sub- 
jection, by  means  of  which  the  bondage  is  expressed,  are  per- 
formed at  the  command  of  the  ruling  individual,  to  satisfy  self- 
ishness, etc.  For  the  subordinated  individual  they  have  no 
independent  purpose ;  they  are  only  the  means  to  an  end, — to 
obtain  or  retain  possession  of  the  ruling  individual.  Finally, 
bondage  is  a  result  of  love  for  a  particular  person ;  it  first 
appears  when  this  love  is  awakened. 

In  masochism,  which  is  decidedly  abnormal  and  a  perver- 
sion, this  is  all  very  different.  The  motive  of  the  acts  and  suf- 
fering of  the  person  in  subjection  is  here  the  charm  afforded  by 
the  tyranny  in  itself.  There  may,  at  the  same  time,  be  a  desire 
for  coitus  with  the  dominant  person ;  but  the  impulse  is 
directed  to  the  acts  which  serve  to  express  the  tyranny,  as  the 
immediate  objects  of  gratification.     These  acts  in  which  maso- 

1  Cases  may  occur  in  which  the  sexual  bondage  is  expressed  in  the  same  acts  that 
are  common  in  masochism.  When  rough  men  whip  their  wives,  and  the  latter  suffer  for 
love,  without,  however,  haviug  a  desire  for  blows,  we  have  a  pseudo  form  of  bondage  that 
may  simulate  masochism. 


MASOCHISM.  145 

chism  is  expressed  are,  for  the  individual  in  subjection,  not  means 
to  an  end,  as  in  bondage,  but  the  end  in  themselves.  Finally,  in 
masochism  the  longing  for  subjection  occurs  a  priori,  before  the 
occurrence  of  an  inclination  to  any  particular  object  of  love. 

The  connection  between  bondage  and  masochism  may  be 
assumed  by  reason  of  the  correspondence  of  the  two  phenomena 
in  the  objective  condition  of  dependence,  notwithstanding  the 
difference  in  their  motives ;  and  the  transformation  of  the  abnor- 
mality into  the  perversion  probably  takes  place  in  the  following 
manner :  Any  one  living  for  a  long  time  in  sexual  bondage  be- 
comes disposed  to  acquire  a  slight  degree  of  masochism.  Love 
that  willingly  bears  the  tyranny  of  the  loved  one  then  becomes 
an  immediate  love  of  tyranny.  When  the  idea  of  being  tyran- 
nized over  is  long  closely  associated  with  the  lustful  thought  of 
the  beloved  person,  the  lustful  emotion  is  finally  connected  with 
the  tyranny  itself  and  the  transformation  to  perversion  is  com- 
pleted. This  is  the  manner  in  which  masochism  may  be  acquired 
by  cultivation.1 

1  It  is  very  interesting,  and  dependent  upon  the  nature  of  bondage  and  masochism, 
which  essentially  correspond  In  external  effects,  that  to  illustrate  the  former  certain  playful, 
metaphorical  expressions  are  in  general  use ;  such  as  "  slavery,"  "  to  bear  chains," 
"  bound,"  "  to  hold  the  whip  over,"  "to  harness  to  the  triumphal  car,"  "to  lie  at  the 
feet,"  "  hen-pecked,"  etc., — all  things  which,  literally  carried  out,  form  the  objects  of  the 
masochist's  desire.  Such  similes  are  frequently  used  in  daily  life  and  have  become  trite. 
They  are  derived  from  the  language  of  poetry.  Poetry  has  always  recognized,  within  the 
general  idea  of  the  passion  of  love,  the  element  of  dependence  in  the  lover,  who  practices 
self-sacrifice  spontaneously  or  of  necessity.  The  facts  of  "bondage"  have  also  always 
presented  themselves  to  the  poetical  imagination.  When  the  poet  chooses  such  expressions 
as  those  mentioned,  to  picture  the  dependence  of  the  lover  in  striking  similes,  he  proceeds 
exactly  as  does  the  masochvit,  who,  to  intensify  the  idea  of  his  dependence  (his  ultimate  aim), 
creates  such  situations  in  reality.  In  ancient  poetry,  the  expression  "  domina"  is  used  to 
signify  the  loved  one,  with  a  preference  for  the  simile  of  "  casting  in  chains  "  {e.g.,  Horace, 
Od.  iv,  11).  From  antiquity  through  all  the  centuries  to  our  own  times  (comp.  Grillparzer, 
"Ottokar,"  Actv  :  "  To  rule  is  sweet,  almost  as  sweet  as  toobey"),  the  poetry  of  love  is  filled 
with  similar  phrases  and  similes.  The  history  of  the  word  "  mistress  "  is  also  interesting. 
But  poetry  reacts  on  life.  It  is  probable  that  the  courtly  chivalry  of  the  Middle  Ages  arose 
in  this  way.  In  its  reverence  for  women  as  "  mistresses  "  in  society  and  in  individual  love- 
relations  ;  its  transference  of  the  relations  of  feudalism  and  vassalage  to  the  relation  between 
the  knight  and  his  lady  ;  its  submission  to  all  feminine  whims  ;  its  love-tests  and  vows  ;  its 
duty  of  obedience  to  every  command  of  the  lady, — in  all  thisr  chivalry  appears  as  a  sys- 
tematic, poetical  development  of  the  "  bondage  "  of  love.  Certain  extreme  manifestations, 
like  the  deeds  and  suffering  of  Ulrich  von  Lichtenstein  or  Pierre  Vidal  in  the  service  of 
their  ladies;  or  the  practice  of  the  fraternity  of  the  "Galois"  in  France,  whose  members 
sought  martyrdom  in  love  and  subjected  themselves  to  all  kinds  of  suffering, — these  clearly 
have  a  masochistic  character,  and  demonstrate  the  natural  transformation  of  one  phenom- 
enon into  the  other. 

10 


146  PSYCHOPATHIA    SEXUALIS. 

Thus  a  mild  degree  of  masochism  may  arise  from  "  bondage," 
— become  acquired;  but  genuine,  complete,  deep-rooted  maso- 
chism, with  its  feverish  longing  for  subjection  from  the  time  of 
earliest  youth,  is  congenital. 

The  explanation  of  the  origin  of  the  infrequent  perversion 
of  fully  developed  masochism  is  most  probably  to  be  found  in 
the  assumption  that  it  arises  from  the  very  frequent  abnormality 
of  "  sexual  bondage  " ;  in  that  now  and  then  this  abnormality  is 
hereditarily  transferred  to  a  psychopathic  individual  in  such  a 
way  that  it  becomes  transformed  into  a  perversion.  It  has  been 
previously  shown  how  a  slight  displacement  of  the  psychical 
element  under  consideration  may  effect  this  transition. 

This  transformation  of  the  abnormality  into  the  perversion, 
through  hereditary  transference,  would  take  place  very  easily 
where  the  psychopathic  constitution  of  the  descendant  presented 
the  other  factor  of  masochism, — i.e.,  what  has  been  previously 
called  its  main  root, — the  tendency  of  sexually  hyperassthetic 
natures  to  assimilate  all  impressions  coming  from  the  beloved 
person  with  the  sexual  impression. 

From  these  two  elements, — from  "  sexual  bondage  "  on  the 
one  hand,  and  from  the  above-mentioned  disposition  to  sexual 
ecstasy,  which  apperceives  even  maltreatment  with  lustful  emo- 
tion, on  the  other, — the  roots  of  which  may  be  traced  back  to 
the  field  of  physiological  facts,  masochism  arises  on  the  basis 
of  psychopathic  predisposition ;  in  that  its  sexual  hyperesthesia 
intensifies  first  all  the  physiological  accessories  of  the  vita 
sexualis  and,  finally,  only  its  abnormal  accompaniments,  to  the 
pathological  degree  of  perversion.1 

1  If  it  be  considered  that,  as  6hown  above,  "sexual  bondage  "is  a  phenomenon 
observed  much  more  frequently  and  in  a  more  pronounced  degree  in  the  female  sex  than  in 
the  male,  the  thought  arises  that  masochism  (if  not  always,  at  least  as  a  rule)  is  an  inher- 
itance of  the  "bondage"  of  feminine  experience.  Thus  it  comes  into  a  relation — though 
distant — with  contrary  sexual  instinct,  as  a  transference  to  the  male  of  a  perversion  really 
belonging  to  the  female.  This  conception  of  masochism  as  a  rudimentary  contrary  sexual 
instinct,  as  a  partial  effemination,  here  affecting  only  the  secondary  sexual  character  of  the 
vita  6exualis  (a  theory  still  more  unconditionally  expressed  in  the  sixth  edition  of  this 
work)  finds  its  support  in  the  statements  of  the  subjects  of  Case  44  and  Case  50,  who  pre- 
sent other  features  of  effemination,  and  give  as  their  ideal  a  relatively  old  woman  who 
seeks  and  wins  them  ;  and,  further,  in  the  fact  that  the  (potent)  masochist  prefers  the  rdle 
of  succubus,  as  shown  by  statements  referring  to  this. 

It  must,  however,  be  emphasized  that  "  bondage  "  also  plays  no  unimportant  rdle  in 


MASOCHISM.  147 

At  any  rate,  masochism,  as  a  congenital  sexual  perversion, 
constitutes  a  functional  sign  of  degeneration  in  (almost  exclus- 
ively) hereditary  taint ;  and  this  clinical  deduction  is  confirmed 
in  my  cases  of  masochism  and  sadism.  It  is  easy  to  demon- 
strate that  the  peculiar,  psychically-anomalous  direction  of  the 
vita  sexualis  which  masochism  represents,  is  an  original  abnor- 
mality, and  not,  so  to  speak,  cultivated  in  a  predisposed  indi- 
vidual by  passive  flagellation,  through  association  of  ideas,  as 
Rousseau  and  Binet  suppose.  This  is  shown  by  the  numerous 
cases  of  masochism — in  fact,  the  majority — in  which  flagellation 
never  appears ;  in  which  the  perverse  impulse  is  directed  ex- 
clusively to  purely  symbolic  acts  expressing  subjection  without 
any  actual  infliction  of  pain.  This  is  demonstrated  by  the 
whole  series  of  cases,  from  Case  53,  given  here. 

The  same  result — namely,  that  passive  flagellation  is  not 
the  nucleus  around  which  all  the  rest  is  gathered — is  reached 
when  closer  study  is  given  to  the  cases  in  which  passive  flagel- 
lation plays  a  role,  as  in  Case  44  and  Case  50.  Case  51  is 
particularly  instructive  in  relation  to  this ;  for  in  this  instance 
there  can  be  no  thought  of  a  sexually-stimulating  effect  of 
punishment  received  in  youth.  Moreover,  in  this  case,  connec- 
tion with  an  early  experience  is  not  possible ;  for  the  situation 
constituting  the  object  of  principal  sexual  interest  is  absolutely 
incapable  of  being  carried  out  by  a  child. 

Finally,  the  origin  of  masochism  in  purely  psychical  ele- 
ments, on  confronting  it  with  sadism  (v.  infra),  is  convincingly 
demonstrated.  That  passive  flagellation  occurs  so  frequently  in 
masochism  is  explained  simply  by  the  fact  that  it  is  the  most 
extreme  means  of  expressing  the  relation  of  subjection. 

I  repeat  that  the  decisive  points,  in  the  differentiation  of 
simple  passive  flagellation  from  flagellation  dependent  upon 
masochistic  desire,  are  that,  in  the  former,  the  act  is  a  means  to 
make  coitus,  or  at  least  ejaculation,  possible ;  and  that,  in  the 
latter,  it  is  a  means  of  gratification  of  masochistic  desires. 

the  masculine  vita  sexualis,  and  that  masochism  in  man  may  also  be  explained  without  any 
such  transference  of  feminine  elements.  It  must  also  be  remembered  here  that  masochism, 
as  well  as  its  counterpart,  sadism,  occurs  in  irregular  combination  with  contrary  sexual 
instinct. 


148  PSYCHOPATHIA    SEXUALIS. 

As  we  have  already  seen,  masochists  subject  themselves  to 
all  other  kinds  of  maltreatment  and  suffering  in  which  there 
can  be  no  question  of  reflex  excitation  of  lust.  Since  such 
cases  are  numerous,  in  such  acts  (and  in  flagellation  in  maso- 
chists, having  like  significance)  we  must  seek  to  ascertain  in 
what  relation  pain  and  lust  stand  to  each  other..  From  the 
statement  of  a  masochist  it  is  as  follows: — 

The  relation  is  not  of  such  a  nature  that  that  which 
causes  physical  pain  is  here  simply  perceived  as  physical  pleas- 
ure ;  but  the  person  in  a  state  of  masochistic  ecstasy  feels  no 
pain ;  either  because,  by  reason  of  his  emotional  state  (like  that 
of  the  soldier  in  battle),  the  physical  effect  on  his  cutaneous 
nerves  is  not  apperceived  ;  or  because  (as  with  religious  martyrs 
and  enthusiasts),  with  the  preoccupation  of  consciousness  with 
lustful  emotion,  the  idea  of  maltreatment  remains  merely  a 
symbol,  without  its  quality  of  pain. 

To  a  certain  extent  there  is  over-compensation  of  physical 
pain  in  psychical  pleasure ;  and  only  the  excess  remains  in  con- 
sciousness as  psychical  lust.  This  also  undergoes  an  increase ; 
since,  either  through  reflex  spinal  influence  or  through  a  pecu- 
liar coloring  in  the  sensorium  of  sensory  impressions,  a  kind  of 
hallucination  of  bodily  pleasure  takes  place,  with  a  vague  local- 
ization of  the  objectively  projected  sensation. 

In  the  self-torture  of  religious  enthusiasts  (fakirs,  howling 
dervishes,  religious  flagellants)  there  is  an  analogous  state,  only 
with  a  difference  in  the  quality  of  pleasurable  feeling.  Here  the 
conception  of  martyrdom  is  also  apperceived  without  its  pain ; 
for  consciousness  is  filled  with  the  pleasurably  colored  idea  of 
serving  God,  atoning  for  sins,  deserving  heaven,  etc.,  through 
martyrdom. 

Masochism  and  Sadism. 

The  perfect  counterpart  of  masochism  is  sadism.  While 
in  the  former  there  is  a  desire  to  suffer  and  be  subjected  to  vio- 
lence, in  the  latter  the  wish  is  to  inflict  pain  and  use  violence. 

The  parallelism  is  perfect.  All  the  acts  and  situations 
used  by  the  sadist  in  the  active  role  become  the  object  of  the 


MASOCHISM   AND   SADISM.  149 

desire  of  the  mosochist  in  the  passive  role.  In  both  perver- 
sions these  acts  advance  from  purely  symbolic  acts  to  severe 
maltreatment.  Even  murder,  in  which  sadism  reaches  its  acme, 
finds,  as  is  shown  by  Case  54, — of  course,  only  in  fancy, — its 
passive  counterpart.  Under  favoring  conditions,  both  perver- 
sions may  occur  with  a  normal  vita  sexualis ;  in  both,  the  acts 
in  which  they  express  themselves  are  preparatory  for  coitus  or 
substitutes  for  it.1 

But  the  analogy  does  not  exist  simply  in  external  manifes- 
tation ;  it  also  extends  to  the  subjective  character  of  both  per- 
versions. Both  are  to  be  regarded  as  original  psychopathies  in 
mentally  abnormal  individuals,  who,  in  particular,  are  affected 
with  psychical  hypersesthesia  sexualis,  and,  as  a  rule,  also  with 
other  abnormalities ;  and  for  each  of  these  perversions  two  con- 
stituent elements  may  be  demonstrated,  which  have  their  roots 
in  psychical  facts  lying  within  physiological  limits.  For  maso- 
chism, as  shown  above,  these  elements  lie  in  the  fact  (1)  that 
in  the  state  of  sexual  emotion  every  impression  produced  by 
the  consort,  independently  of  the  manner  of  its  production,  is, 
per  se,  attended  with  lustful  pleasure,  which,  where  there  is 
hyperesthesia  sexualis,  may  go  so  far  as  to  over-compensate  all 
painful  sensation ;  and  in  the  fact  (2)  that  "  sexual  bondage," 
dependent  on  mental  factors  that  are  in  themselves  not  perverse, 
may,  under  pathological  conditions,  become  a  perverse,  pleasur- 
able desire  for  subjection  to  the  opposite  sex,  which — even  if  it 
be  quite  unnecessary  to  assume  its  inheritance  from  the  female 
side — represents  a  pathological  degeneration  of  the  character 
belonging  to  woman, — of  the  instinct  of  subordination,  physio- 
logical in  woman. 

In  harmony  with  this,  there  are,  likewise,  two  constituent 
elements  explanatory  of  sadism,  the  origin  of  which  may  also  be 


1  Of  course,  both  have  to  contend  with  opposing  ethical  and  aesthetic  motives  in 
foro  interno.  After  these  have  been  overcome  and  sadism  appears,  it  immediately  comes  in 
conflict  with  the  law.  This  is  not  the  case  with  masochism  ;  which  accounts  for  the  greater 
frequency  of  masochistic  acts.  But  the  instinct  of  self-preservation  and  fear  of  pain  oppose 
the  realization  of  the  latter.  The  practical  significance  of  masochism  lies  only  in  its  rela- 
tions to  psychical  impotence ;  while  that  of  6adism  lies  beyond  that,  and  is  principally 
forensic. 


150  FSYCHOPATHIA   SEXUALIS. 

traced  back  within  physiological  limits.  These  are :  the  fact  (1) 
that  in  sexual  emotion,  to  a  certain  extent,  as  an  accompany- 
ing psychical  excitation,  an  impulse  may  arise  to  influence 
the  object  of  desire  in  every  possible  way  and  with  the  greatest 
possible  intensity,  which,  in  individuals  sexually  hyperaes- 
thetic,  may  become  an  impulse  to  inflict  pain ;  and  the  fact 
(2)  that,  under  pathological  conditions,  the  man's  active  role 
of  winning  woman  may  become  an  unlimited  desire  for  sub- 
jugation. 

Thus  masochism  and  sadism  represent  perfect  counterparts. 
It  is  also  in  harmony  with  this  that  the  individuals  affected  with 
these  perversions  regard  the  opposite  perversion  in  the  other 
sex  as  their  ideal,  as  shown  by  Case  44  and  Case  50,  and  also  by 
"  Rousseau's  Confessions." 

But  the  contrast  of  masochism  and  sadism  may  also  be  used 
to  invalidate  the  assumption  that  the  former  has  its  origin  in  the 
reflex  effect  of  passive  flagellation ;  and  that  all  the  rest  is  the 
product  of  associations  of  related  ideas,  as  Binet,  in  explanation 
of  Rousseau's  case,  thinks,  and  as  Rousseau  himself  believed. 

In  the  active  maltreatment  forming  the  object  of  the 
sadist's  sexual  desire  there  is,  in  fact,  no  irritation  of  his 
own  sensory  nerves  by  the  act  of  maltreatment ;  so  that  there 
can  be  no  doubt  of  the  purely  psychical  character  of  the  origin 
of  this  perversion.  Sadism  and  masochism,  however,  are  so 
related  to  each  other,  and  so  correspond  in  all  points  with  each 
other,  that  the  one  allows,  by  analogy,  a  conclusion  for  the  other,; 
and  this  is  alone  sufficient  to  establish  the  purely  psychical 
character  of  masochism. 

According  to  the  above-detailed  contrast  of  all  the  elements 
and  phenomena  of  masochism  and  sadism,  and  as  a  resumi  of 
all  observed  cases,  lust  in  the  infliction  of  pain  and  lust  in  in- 
flicted pain  appear  but  as  two  different  sides  of  the  same 
psychical  process,  of  which  the  primary  and  essential  thing  is 
the  consciousness  of  active  or  passive  subjection,  in  which  the 
combination  of  cruelty  and  lustful  pleasure  has  only  a  secondary 
psychological  significance.  Acts  of  cruelty  serve  to  express  this 
subjection;  first,  because  they  are  the  most  extreme  means  for 


MASOCHISM   AND   SADISM.  151 

the  expression  of  this  relation;  and,  again,  because  they  represent 
the  most  intense  effect  that  one  person,  either  with  or  without 
coitus,  can  exert  on  another. 

The  cases  in  which  sadism  and  masochism  occur  simul- 
taneously in  one  individual  are  interesting,  but  they  pre- 
sent some  difficulties  of  explanation.  Cases  49,  50,  58,  etc., 
are  of  this  kind,  and  also  particularly  Case  30.  From  the 
latter  it  is  evident  that  it  is  especially  the  idea  of  subjection 
that,  both  actively  and  passively,  forms  the  nucleus  of  the 
perverse  desires.  Traces  of  the  same  thing  are  also  to  be 
observed,  with  more  or  less  clearness,  in  many  other  cases. 
At  any  rate,  one  of  the  two  perversions  is  always  markedly 
predominant. 

Owing  to  this  marked  predominance  of  one  perversion, 
and  the  later  appearance  of  the  other,  in  such  cases  it  may 
well  be  assumed  that  the  predominating  perversion  is  original, 
and  that  the  other  has  been  acquired  in  the  course  of  time. 
The  ideas  of  subjection  and  maltreatment,  colored  with  lust- 
ful pleasure,  either  in  an  active  or  passive  sense,  have  be- 
come deeply  impressed  in  such  an  individual. 

Occasionally  the  imagination  is  tempted  to  try  the  same 
ideas  in  an  inverted  role.  There  may  even  be  realization  of 
this  inversion.  Such  attempts  in  imagination  and  in  acts, 
however,  are  usually  soon  abandoned  as  inadequate  for  the 
original  inclination. 

Masochism  and  sadism  also  occur  in  combination  with  con- 
trary sexual  instinct,  and,  too,  in  association  with  all  forms  and 
degrees  of  this  perversion.  The  individual  of  contrary  sexuality 
may  be  a  sadist  as  well  as  masochist  (comp.  Cases  48  and  49  and 
numerous  cases  in  the  following  series  of  cases  of  contrary 
sexual  instinct). 

"Wherever  a  sexual  perversion  has  developed  on  the  basis 
of  a  neuropathic  individuality,  sexual  hyperesthesia,  which  may 
always  be  assumed  to  be  present,  may  induce  the  phenomena 
of  masochism  and  sadism — now  of  the  one,  now  of  both  com- 
bined, one  arising  from  the  other.  Thus  masochism  and  sadism 
appear  as  the  fundamental  forms  of  psycho-sexual  perversion, 


152  PSYCHOPATHIA   SEXUALIS. 

which  may  make  their  appearance  at  any  point  in  the  domain 
of  sexual  aberration.1 

3.  The  Association  of  Lust  with  the  Idea  of  Certain  Por- 
tions of  the  Female  Person,  or  with  Certain  Articles  of  Female 
Attire — Fetichism. — In  the  considerations  concerning  the  psy- 
chology of  the  normal  sexual  life  in  the  introduction  to  this 
work  (vide  p.  17),  it  was  shown  that,  within  physiological  limits, 
the  pronounced  preference  for  a  certain  portion  of  the  body  of 
persons  of  the  opposite  sex,  particularly  for  a  certain  form  of 
this  part,  may  attain  great  psycho-sexual  importance.  Indeed, 
the  especial  power  of  attraction  possessed  by  certain  forms  and 
peculiarities  for  many  men — in  fact,  the  majority — may  be 
regarded  as  the  real  principle  of  individualization  in  love. 

This  preference  for  certain  particular  physical  characteristics 
in  persons  of  the  opposite  sex, — by  the  side  of  which,  likewise, 
a  marked  preference  for  certain  psychical  characteristics  may  be 
demonstrated, — following  Binet  ("  du  Fetischisme  dans  1' amour," 
Revue  philosophique,  1887)  and  Lombroso  (Introduction  to 
the  Italian  edition  of  the  second  edition  of  this  work),  I  have 
called  "  fetichism  " ;  because  this  enthusiasm  for  certain  portions 

1  Every  attempt  to  explain  the  facts  of  either  sadism  or  masochism,  owing  to  the 
close  connection  of  the  two  phenomena  demonstrated  here,  must  also  be  suited  to  explain 
the  other  perversion.  An  attempt  to  offer  an  explanation  of  sadism,  by  J.  G.  Kiernan  (Chi- 
cago) (vide  "  Psychological  Aspects  of  the  Sexual  Appetite,"  Alienist  and  Neurologist, 
St.  Louis,  April,  1891)  meets  this  requirement,  and  for  this  reason  may  be  briefly  mentioned 
here.  Kiernan,  who  has  several  authorities  in  Anglo-American  literature  for  his  theory, 
starts  from  the  assumption  of  several  naturalists  (Dallinger,  Drysdale,  Rolph,  Cienkowsky) 
which  conceives  the  so-called  conjugation,  a  sexual  act  in  certain  low  forms  of  animal  life, 
to  be  cannibalism,  a  devouring  of  the  partner  in  the  act.  He  brings  into  immediate  con- 
nection with  this  the  well-known  facts  that  at  the  time  of  sexual  union  crabs  tear  limbs  from 
their  bodies  and  spiders  bite  off  the  heads  of  the  males,  and  other  sadistic  acts  performed 
by  rutting  animals  with  their  consorts.  From  this  he  passes  to  lust-murder  and  other  lustful 
acts  of  cruelty  in  man,  and  assumes  that  hunger  and  the  sexual  appetite  are,  in  their  origin, 
identical ;  that  the  sexual  cannibalism  of  lower  forms  of  animal  life  has  an  influence  in 
higher  forms  and  in  man,  and  that  sadism  is  an  example  of  atavism. 

This  explanation  of  sadism  would,  of  course,  also  explain  masochism ;  for  if  the 
origin  of  sexual  intercourse  is  to  be  sought  in  cannibalistic  processes,  then  both  the  sur- 
vival of  one  sex  and  the  destruction  of  the  other  would  fulfill  the  purpose  of  nature,  and 
thus  the  instinctive  desire  to  be  the  victim  would  be  explained.  But  it  must  be  stated  in* 
objection  that  the  basis  of  this  reasoning  is  insufficient.  The  extremely  complicated  pro- 
cess of  conjugation  in  lower  organisms,  into  which  science  has  really  penetrated  only 
during  the  last  few  years,  is  by  no  means  to  be  regarded  as  simply  a  devouring  of  one  indi- 
vidual by  another  (comp.  Weismann,  Die  Bedeutung  der  Sexuelleu  Fortpflanzung  fur  die 
Selectionstheorie,  p.  51,  Jena,  1886). 


FETICHISM.  153 

of  the  body  (or  even  articles  of  attire)  and  the  worship  of  them, 
in  obedience  to  sexual  impulses,  frequently  call  to  mind  the 
reverence  for  relics,  holy  objects,  etc.,  in  religious  cults.  This 
physiological  fetichism  has  already  been  described  in  detail  on 
page  17  et  seq. 

By  the  side  of  this  physiological  fetichism,  however,  there 
is,  in  the  psycho-sexual  sphere,  an  undoubted  pathological,  erotic 
fetichism,  of  which  there  is  already  a  numerous  series  of  cases 
presenting  phenomena  having  great  clinical  and  psychiatric 
interest,  and,  under  certain  circumstances,  forensic  importance. 
This  pathological  fetichism  does  not  confine  itself  to  certain  parts 
of  the  body  alone,  but  it  is  even  extended  to  inanimate  objects, 
which,  however,  are  almost  always  articles  of  female  wearing- 
apparel,  and  thus  stand  in  close  relation  with  the  female  person. 

This  pathological  fetichism  is  connected,  through  gradual 
transitions,  with  physiological  fetichism ;  so  that  (at  least  in 
body-fetichism)  it  is  almost  impossible  to  sharply  define  the 
beginning  of  the  perversion.  Moreover,  the  whole  field  of 
body-fetichism  does  not  really  extend  beyond  the  limits  of 
things  which  normally  stimulate  the  sexual  instinct.  Here  the 
abnormality  consists  only  in  the  fact  that  the  whole  sexual 
interest  is  concentrated  on  the  impression  made  by  a  part  of 
the  person  of  the  opposite  sex,  so  that  all  other  impressions 
fade  and  become  more  or  less  indifferent.  Therefore,  the  body- 
fetichist  is  not  to  be  regarded  as  a  monstrum  per  excessum,  like 
the  sadist  or  masochist,  but  rather  as  a  monstrum  per  defectum. 
What  stimulates  him  is  not  abnormal,  but  rather  what  does  not 
affect  him, — the  limitation  of  sexual  interest  that  has  taken 
place  in  him.  Of  course,  this  limited  sexual  interest,  within  its 
narrower  limits,  is  usually  expressed  with  a  correspondingly 
greater  and  abnormal  intensity. 

It  would  seem  reasonable  to  assume,  as  the  distinguishing 
mark  of  pathological  fetichism,  the  necessity  for  the  presence  of 
the  fetich  as  a  conditio  sine  qua  non  for  the  possibility  of  per- 
formance of  coitus.  But  when  the  facts  are  more  carefully 
studied,  it  is  seen  that  this  limitation  is  really  only  indefinite. 
There  are  numerous  cases  in  which,  even  in  the  absence  of  the 


154  PSYCHOPATHIA   SEXUALlS. 

fetich,  coitus  is  possible,  but  it  is  incomplete  and  forced  (often 
with  the  help  of  fancies  relating  to  the  fetich),  and  particularly 
unsatisfying  and  exhausting ;  and,  too,  closer  study  of  the  dis- 
tinctive subjective  psychical  conditions  in  these  cases  shows  that 
there  are  transitional  states,  passing,  on  the  one  hand,  to  mere 
physiological  preferences,  and,  on  the  other,  to  psychical  impo- 
tence in  the  absence  of  the  fetich.  It  is  therefore  better,  per- 
haps, to  seek  the  pathological  criterion  of  body-fetichism  in 
purely  subjective  psychical  states.  The  concentration  of  the 
sexual  interest  on  a  certain  portion  of  the  body  that  has 
no  direct  relation  to  sex  (as  have  the  mammas  and  external 
genitals) — a  peculiarity  to  be  emphasized — often  leads  body- 
fetichists  to  such  a  condition  that  they  do  not  regard  coitus  as 
the  real  means  of  sexual  gratification,  but  rather  some  form  of 
manipulation  of  that  portion  of  the  body  that  is  effectual  as  a 
fetich.  This  perverse  instinct  of  body-fetichists  may  be  taken 
as  the  pathological  criterion,  no  matter  whether  actual  coitus  is 
also  possible  or  not. 

Fetichism  of  inanimate  objects  or  articles  of  dress,  how- 
ever, in  all  cases,  may  well  be  regarded  as  a  pathological  phe- 
nomenon; since  its  objects  fall  without  the  circle  of  normal 
sexual  stimuli.  But  even  here,  in  the  phenomena,  there  is  a 
certain  outward  correspondence  with  processes  of  the  normal 
psychical  vita  sexualis ;  the  inner  connection  and  meaning  of 
pathological  fetichism,  however,  are  entirely  different.  In  the 
ecstatic  love  of  a  man  mentally  normal,  a  handkerchief  or  shoe, 
a  glove  or  letter,  the  flower  "  she  gave,"  or  a  lock  of  hair,  etc., 
may  become  the  object  of  worship,  but  only  because  they  repre- 
sent a  mnemonic  symbol  of  the  beloved  person — absent  or  dead 
— whose  whole  personality  is  reproduced  by  them.  The  patho- 
logical fetichist  has  no  such  relations.  The  fetich  constitutes 
the  entire  content  of  his  idea.  When  he  is  possessed  by  it, 
sexual  excitement  occurs,  and  the  fetich  makes  itself  felt.1 

According  to  all  observations  thus  far  made,  pathological 

1  In  Zola's  "  Theresc  Raquiu,"  where  the  lover  repeatedly  kisses  his  mistress's  boot, 
the  case  is  quite  different  from  that  of  shoe-  and  boot-  fetichists,  who,  at  the  sight  of  every 
boot  worn  by  a  lady,  or  even  alone,  are  thrown  into  sexual  excitement,  even  to  the  extent 
of  ejaculation. 


FETICHISM,  155 

fetichism  seems  to  arise  only  on  the  basis  of  a  psychopathic  con- 
stitution that  is  for  the  most  part  hereditary,  or  on  the  basis  of 
existent  mental  disease. 

Thus  it  happens  that  it  not  infrequently  appears  combined 
with  the  other  (original)  sexual  perversions  that  arise  on  the 
same  basis.  Not  infrequently  fetichism  occurs  in  the  most  various 
forms  in  combination  with  contrary  sexuality,  sadism,  and  maso- 
chism. Indeed,  certain  forms  of  body- fetichism  (hand-  and 
foot-  fetichism)  probably  have  a  more  or  less  distinct  connection 
with  the  latter  two  perversions  (v.   infra). 

But  if  fetichism  also  rests  upon  a  congenital  general  psycho- 
pathic disposition,  yet  this  perversion  is  not,  like  those  previously 
considered,  essentially  of  an  original  nature ;  it  is  not  congeni- 
tally  perfect,  as  we  may  well  assume  sadism  and  masochism  to 
be.  While  in  the  sexual  perversions  thus  far  described  we 
have  met  only  cases  of  a  congenital  nature,  here  we  meet  only 
acquired  cases.  Aside  from  the  fact  that  in  fetichism  the  causa- 
tive circumstance  of  its  acquirement  is  often  demonstrable,  here 
the  physiological  conditions  are  wanting,  which  in  sadism  and 
masochism,  by  means  of  sexual  hyperesthesia,  are  intensified  to 
perversions,  and  justify  the  assumption  of  congenital  origin.  In 
fetichism,  every  case  requires  an  event  which  affords  the  subject 
of  perversion.  As  has  been  said,  it  is,  of  course,  physiological 
in  sexual  life  to  be  partial  to  one  or  another  of  woman's  pecu- 
liarities, and  to  be  enthusiastic  about  it ;  but  concentration  of 
the  entire  sexual  interest  on  such  partial  impressions  is  here  the 
essential  thing ;  and  for  this  concentration  there  must  be  a  par- 
ticular reason  in  every  individual  affected.  Therefore,  we  may 
accept  Binet's  conclusion  that  in  the  life  of  every  fetichist  there 
may  be  assumed  to  have  been  some  event  which  determined  the 
association  of  lustful  feeling  with  the  single  impression.  This 
event  is  to  be  referred  to  the  time  of  early  youth,  and,  as  a  rule, 
occurs  in  connection  with  the  first  awakening  of  the  vita  sexualis. 
This  first  awakening  is  associated  with  some  partial  sexual  im- 
pression (since  it  is  always  something  standing  in  some  relation 
to  woman),  and  stamps  it  for  life  as  the  principal  object  of  sexual 
interest.     The  circumstances  under  which  the  association  arises 


156  PSYCHOPATHIA   SEXUALIS. 

are  usually  forgotten.  It  is  only  the  result  of  the  association 
that  is  retained.  The  general  predisposition  to  psychopathic 
states  and  the  sexual  hyperesthesia  of  such  individuals  are  all 
that  is  original  here.1 

Like  the  other  perversions  thus  far  considered,  erotic  (patho- 
logical) fetichism  may  also  express  itself  in  strange,  unnatural, 
and  even  criminal  acts  :  gratification  with  the  female  person  loco 
indebito,  theft  and  robbery  of  objects  of  fetichism,  pollution  of 
such  objects,  etc.  Here,  too,  it  only  depends  upon  the  intensity 
of  the  perverse  impulse  and  the  relative  power  of  opposing 
ethical  motives,  whether  and  to  what  extent  such  acts  are  per- 
formed. These  perverse  acts  of  fetichists,  like  those  of  other 
sexually  perverse  individuals,  may  either  alone  constitute  the 
entire  external  vita  sexualis,  or  occur  together  with  the  normal 
sexual  act.  This  depends  upon  the  condition  of  physical  and 
psychical  sexual  power,  and  the  degree  of  excitability  to  normal 
stimuli  that  has  been  retained.  Where  excitability  is  dimin- 
ished, not  infrequently  the  sight  or  touch  of  the  fetich  serves  as 
a  necessary  preparatory  act. 

The  great  practical  importance  which  attaches  to  the  facts 
of  fetichism,  in  accordance  with  what  has  been  said,  lies  in  two 
factors.  First,  pathological  fetichism  is  not  infrequently  a  cause 
of  psychical  impotence.2  Since  the  object  upon  which  the  sexual 
interest  of  the  fetichist  is  concentrated  stands,  in  itself,  in  no 
immediate  relation  to  the  normal  sexual  act,  it  often  happens 
that  the  fetichist  diminishes  his  excitability  to  normal  stimuli 


1  Though  Binet  (op.  cit.)  declares  that  every  sexual  perversion,  without  exception, 
depends  upon  such  an  "  accident  acting  on  a  predisposed  subject"  (where,  under  predis- 
position, only  hyperesthesia  in  general  is  understood),  yet  such  an  assumption  for  other  per- 
versions than  fetichism  is  neither  necessary  nor  satisfactory.  For  example,  it  is  not  clear 
how  the  sight  of  another's  punishment  could  excite  sexually  even  a  very  excitable  individual, 
if  the  physiological  relationship  of  lust  and  cruelty  had  not  been  developed  into  original 
sadism  in  an  abnormally  excitable  individual. 

2  When  young  husbands  whojhave  associated  much  with  prostitutes  feel  impotent 
in  the  face  of  the  chastity  of  their  young  wives — a  thing  that  frequently  occurs — the  con- 
dition may  be  regarded  as  a  kind  of  (psychical)  fetichism  in  a  wider  sense.  One  of  my 
patients  was  never  potent  with  his  beautiful  and  chaste  young  wife,  because  he  was  accus- 
tomed to  the  lascivious  methods  of  prostitutes.  When  he  now  and  then  attempted  coitus 
with  puellis  he  was  perfectly  potent.  Hammond  (op.  tit.)  reports  a  very  similar  interesting 
case.  Of  course,  in  such  cases,  a  bad  conscience  and  hypochondriacal  fear  of  impotence 
play  an  important  part. 


FETICHISM.  157 

by  his  perversion,  or,  at  least  is  capable  of  coitus  only  by  means 
of  concentration  of  his  fancy  upon  his  fetich.  In  this  perver- 
sion, and  in  the  difficulty  of  its  adequate  satisfaction,  just  as  in 
the  other  perversions  of  the  sexual  instinct,  lie  conditions  favor- 
ing psychical  and  physical  onanism,  which  again  reacts  dele- 
teriously  on  the  constitution  and  sexual  power.  This  is 
especially  true  in  the  case  of  youthful  individuals,  and  par- 
ticularly in  the  case  of  those  who,  on  account  of  opposing 
ethical  and  aesthetic  motives,  shrink  from  the  realization  of 
their  perverse  desires.  Secondly,  fetichism  is  of  great  forensic 
importance.  Just  as  sadism  may  extend  to  murder  and  thn 
infliction  of  bodily  injury,  fetichism  may  lead  to  theft  and  even 
to  robbery  for  the  possession  of  the  desired  articles. 

Erotic  fetichism  has  for  its  object  either  a  certain  portion 
of  the  body  of  a  person  of  the  opposite  sex,  or  a  certain  arti- 
cle or  material  of  wearing-apparel  of  the  opposite  sex.  (Only 
cases  of  pathological  fetichism  in  men  have  thus  far  been  ob- 
served, and  therefore  only  portions  of  the  female  person  and 
attire  are  spoken  of  here.)  In  accordance  with  this,  fetichists 
fall  into  three  groups. 

(a)  The  Fetich  is  a  Part  of  the  Female  Body. — Just  as,  in 
physiological  fetichism,  the  eyes,  the  hand,  the  foot,  and  the 
hair  of  woman  very  frequently  become  fetiches,  so,  in  the  path- 
ological domain,  the  same  portions  of  the  body  become  the  sole 
objects  of  sexual  interest.  This  exclusive  concentration  of 
interest  on  these  parts,  by  the  side  of  which  everything  else 
feminine  fades,  and  all  other  sexual  value  of  woman  may  sink 
to  nil,  so  that,  instead  of  coitus,  strange  manipulations  of  the 
fetich  become  the  object  of  desire, — this  it  is  that  makes  these 
cases  pathological. 

Case  74.  (Binet,  op.  tit.)  X.,  aged  34,  teacher  in  a  Gymnasium. 
In  childhood  he  suffered  with  convulsions.  At  the  age  of  ten  he  began 
to  masturbate,  with  lustful  feelings,  which  were  connected  with  very 
strange  ideas.  He  was  particularly  partial  to  women's  eyes ;  but  since 
he  wished  to  imagine  some  form  of  coitus,  and  was  absolutely  innocent 
in  sexual  matters,  to  avoid  too  great  a  separation  from  the  eyes,  he 
evolved  the  idea  of  making  the  nostrils  the  seat  of  the  female  sexual 
organs.    Then  his  lively  sexual  desires  were  connected  with  this  idea.    He 


158  PSYCHOPATHIA   SEXUALIS. 

sketched  drawings  representing  correct  Greek  profiles  of  female  heads,  but 
the  nostrils  were  so  large  that  immissio  penis  would  have  been  possible. 

One  day y  in  an  omnibus,  he  saw  a  girl  in  whom  he  thought  he  rec- 
ognized his  ideal.  He  followed  her  to  her  home  and  immediately  pro- 
posed to  her.  Shown  the  door,  he  returned  again  and  again,  until 
arrested.     X.  never  had  sexual  intercourse. 

Hand-fetichists  are  very  numerous.  The  following  case  is 
not  really  pathological.    It  is  given  here  as  a  transitional  case : — 

Case  75.  B.,  of  neuropathic  family,  very  sensual,  mentally  intact. 
At  the  sight  of  the  hand  of  a  beautiful  young  lady  he  is  always  charmed 
and  feels  sexual  excitement  to  the  extent  of  ejaculation.  It  is  his  de- 
light to  kiss  and  press  such  hands.  As  long  as  they  are  covered  with 
gloves  he  feels  unhappy.  By  pretexts  he  tries  to  get  hold  of  such  hands. 
He  is  indifferent  to  the  foot.  If  the  beautiful  hands  are  ornamented  with 
rings,  his  lust  is  increased.  Only  the  living  hand,  not  its  image,  causes 
him  this  lustful  excitement.  It  is  only  when  he  is  exhausted  sexually 
by  frequent  coitus  that  the  hand  loses  its  sexual  charm.  At  first  the 
memory-picture  of  female  hands  disturbed  him  even  while  at  work. 
(Binet,  op.  cit.) 

Binet  states  that  such  cases  of  enthusiasm  for  the  female 
hand  are  numerous.  Here  it  may  be  recalled  that,  according 
to  Case  24,  a  man  may  be  partial  to  the  female  hand  as  a  result 
of  sadistic  impulses ;  and  that,  according  to  Case  46,  the  same 
thing  may  be  due  to  masochistic  desires.  Thus  such  cases  have 
more  than  one  meaning.  But  this  is  by  no  means  to  say  that 
all,  or  even  a  majority,  of  the  cases  of  hand-fetichism  allow  or 
require  a  sadistic  or  masochistic  explanation. 

The  following  interesting  case,  that  has  been  studied  in 
detail,  shows  that,  in  spite  of  the  fact  that  at  first  a  sadistic  or 
masochistic  element  seems  to  have  exercised  an  influence,  at  the 
time  of  the  individual's  maturity  and  the  complete  development 
of  the  perversion,  the  latter  contained  nothing  of  these  elements. 
Of  course,  it  is  possible  that,  in  the  course  of  time,  these  disap- 
peared; but  here  the  assumption  of  the  origin  of  the  fetichism 
in  an  accidental  association  meets  every  requirement : — 

Case  76.  A  case  of  hand-fetichism,  communicated  by  Albert  Moll. 
P.  L.,  aged  28,  a  merchant  of  Westphalia.  Aside  from  the  fact  that  the 
patient's  father  was  remarkably  moody  and  somewhat  quick-tempered, 
nothing  of  an  hereditary  nature  could  be  proved  in  the  family.     At 


FETICHISM.  159 

school  the  patient  was  not  very  diligent ;  he  was  never  able  to  concen- 
trate his  attention  on  any  one  subject  for  any  length  of  time ;  on  the 
other  hand,  from  childhood  he  had  a  great  inclination  for  music.  His 
temperament  was  always  nervous. 

In  August,  1890,  he  came  to  me  complaining  of  headache  and 
abdominal  pain,  which  in  every  wa}r  gave  the  impression  of  being  neu- 
rasthenic. The  patient  also  said  he  was  destitute  of  energy.  Only  after 
accurately  directed  questions  did  the  patient  make  the  following  state- 
ments concerning  his  sexual  life.  As  far  as  he  could  remember,  the 
beginnings  of  sexual  excitement  occurred  in  his  seventh  year.  When- 
ever he  saw  a  boy  of  his  own  age  urinate  and  caught  sight  of  his  geni- 
tals, he  became  lustfully  excited.  L.  states  with  certainty  that  this 
excitement  was  associated  with  very  evident  erections.  Led  astray  by 
another  boy,  L.  learned  to  masturbate  at  the  age  of  seven  or  eight. 
"Being  of  a  very  excitable  nature,"  said  L.,  "I  practiced  masturbation 
very  frequently  until  my  eighteenth  year,  without  gaining  any  clear  idea 
of  the  evil  results  or  the  meaning  of  the  practice."  He  was  particularly 
fond  of  practicing  mutual  onanism  with  some  of  his  school-friends,  but 
it  was  by  no  means  an  indifferent  matter  who  the  other  boy  was ;  on  the 
contrary,  only  a  few  of  his  companions  could  satisfy  him  in  this  respect. 
To  the  question  as  to  what  particularly  caused  him  to  prefer  this  or  that 
boy,  L.  replied  that  a  white,  beautifully-formed  hand  in  his  school-fellows 
impelled  him  to  practice  mutual  onanism  with  them.  "  L.  further  remem- 
bered that  frequently,  at  the  beginning  of  the  gymnastic  lesson,  he 
would  exercise  by  himself  on  a  bar  standing  apart.  He  did  this  for  the 
purpose  of  exciting  himself  as  much  as  possible ;  and  he  was  so  success- 
ful that,  without  using  his  hand  and  without  ejaculation, — L.  was  still 
too  young, — he  had  lustful  pleasure.  Another  early  event  which  L. 
remembers  is  interesting.  One  day  his  favorite  companion,  N.,  who 
practiced  mutual  onanism  with  him,  proposed  that  L.  should  try  to  get 
hold  of  his  (N.'s)  penis,  and  he  would  do  all  he  could  to  prevent  it.  L. 
acquiesced.  In  this  wa}^  the  onanism  was  directly  combined  with  a 
struggle  between  both  parties,  in  which  N.  was  always  overcome.  The 
struggle  always  finally  ended  in  N.'s  being  compelled  to  allow  L.  to 
practice  onanism  on  him.  L.  assured  me  that  this  kind  of  masturbation 
had  given  him,  as  well  as  N.,  especial  pleasure.1  In  this  way  L.  contin- 
ued to  practice  masturbation  very  frequently  until  his  eighteenth  year. 
Warned  by  a  friend,  he  then  began  to  struggle  with  all  his  might  against 
his  evil  habit.  He  became  more  and  more  successful,  and  finally,  after 
the  first  performance  of  coitus,  he  stopped  the  practice  of  onanism 
entirely.  But  this  was  only  accomplished  in  his  twenty-second  year.  It 
now  seems  incomprehensible  to  the  patient — and  he  says  he  is  filled  with 
disgust  at  the  thought  of  it — how  he  could  ever  have  found  pleasure  in 

1  A  kind  of  rudimentary  sadism  in  L.  and  masochism  in  N. 


160  PSYCHOPATHIA   SEXUALIS. 

performing  masturbation  with  other  boys.  Now,  nothing  could  induce 
him  to  touch  another  man's  genitals,  the  sight  of  which  is  even  unpleas- 
ant to  him.  He  has  lost  all  inclination  for  men,  and  feels  attracted  by 
women  exclusively. 

It  must  be  mentioned,  however,  that,  though  L.  has  a  decided 
inclination  for  the  female  sex,  he  presents  an  abnormal  phenomenon. 

The  essential  thing  in  woman  that  excites  him  is  the  sight  of  her 
beautiful  hands  ;  L.  is  by  far  more  impressed  when  he  touches  a  beautiful 
female  hand  than  he  would  be  were  he  to  see  its  possessor  in  a  state  of 
complete  nudity.  The  extent  to  which  L.'s  preference  for  beautiful  female 
hands  goes  is  shown  by  the  following  incident : — 

L.  knew  a  beautiful  young  lady  possessed  of  every  charm,  but  her 
hands  were  quite  large  and  not  beautifully  formed,  and  often  the}7  were 
not  as  clean  as  L.  could  wish.  For  this  reason  it  was  not  only  impossible 
for  L.  to  conceive  a  deeper  interest  in  the  lady,  but  he  was  not  able  even 
to  touch  her.  L.  believes  that  there  is  nothing  more  disgusting  to  him 
than  dirty  finger-nails ;  this  alone  would  make  it  impossible  for  him  to 
touch  a  woman  who  in  all  other  respects  was  most  beautiful.  L.  for- 
merly, as  a  substitute  for  coitus,  had  the  puella  perform  genital  manipu- 
lation with  her  hand  until  ejaculation  took  place. 

To  the  question  as  to  what  there  was  about  a  woman's  hand  that 
attracted  him  in  particular,  whether  he  saw  in  it  a  symbol  of  power,  and 
whether  it  gave  him  pleasure  to  be  directly  humiliated  by  a  woman,  the 
patient  answered  that  only  the  beautiful  form  of  the  hand  charmed  him ; 
that  it  afforded  him  no  gratification  to  be  humiliated  by  a  woman ;  and 
that  he  had  never  had  any  thought  to  regard  the  hand  as  the  symbol  or 
instrument  of  a  woman's  power.  The  preference  for  the  hand  is  still 
so  great  that  the  patient  has  greater  pleasure  when  his  genitals  are 
touched  by  it  than  when  he  performs  coitus  in  vaginam.  Yet,  the 
patient  prefers  to  perform  the  latter,  because  it  seems  to  him  to  be 
natural,  while  the  former  seems  abnormal.  The  touch  of  a  beautiful 
female  hand  on  his  body  immediately  causes  him  to  have  erection ;  he 
thinks  that  kissing  and  other  contacts  do  not  exert  nearly  so  strong  an 
influence.  It  is  only  of  late  years  that  the  patient  has  performed  coitus 
frequently,  but  it  has  always  been  very  difficult  for  him  to  determine  to 
do  it.  Too,  in  coitus,  he  did  not  find  the  complete  satisfaction  he  sought. 
However,  when  he  finds  himself  near  a  woman  whom  he  would  like  to 
possess,  sometimes,  at  mere  sight  of  her,  his  sexual  excitement  becomes  so 
intense  that  ejaculation  results.  L.  says  expressly  that  during  this  he 
does  not  intentionally  touch  or  press  his  genitals ;  ejaculation  under  such 
circumstances  affords  him  much  more  pleasure  than  he  experiences  in 
actual  coitus.1 

To  go  back,  the  patient's  dreams  were  never  about  coitus.     When 

1  Great  sexual  hyperaesthesia.    Comp.  note  on  p.  50. 


FETICHISM.  161 

he  had  pollutions  at  night,  they  were  almost  always  associated  with  other 
thoughts  than  those  that  occur  in  the  normal  man.  The  patient's  dreams 
are  of  events  of  his  school-days.  During  his  school-days,  besides  the 
mutual  onanism  described,  he  had  ejaculations  whenever  he  became 
anxiously  excited.  When,  for  example,  the  teacher  dictated  an  extem- 
poraneous exercise,  and  L.  was  unable  to  follow  in  translation,  ejaculation 
often  occurred.1  The  pollutions  that  now  occur  occasionally,  at  night, 
are  only  accompanied  by  dreams  that  have  the  same  or  a  similar  subject, — 
the  events  at  school  just  mentioned.  On  account  of  his  unnatural  feeling 
and  sensibility,  the  patient  thinks  he  is  incapable  of  loving  a  woman  long. 
Treatment  of  the  patient's  perversion  has  not  yet  been  possible. 

This  case  of  hand-fetichism  certainly  does  not  depend  on 
masochism  or  sadism,  bnt  is  to  be  explained  simply  by  early  in- 
dulgence in  mutual  onanism.  There  is  here,  also,  quite  as  little 
of  contrary  sexual  instinct.  Before  the  sexual  appetite  was 
clearly  conscious  of  its  object,  the  hands  of  school-fellows  were 
used.  As  soon  as  the  instinct  for  the  opposite  sex  became  evi- 
dent, the  interest  for  the  hand  was  transferred  to  woman. 

In  hand-fetichists,  who,  according  to  Binet,  are  so  numer- 
ous, it  is  possible  that  other  associations  lead  to  the  same  result. 

Next  to  the  hand-fetichists,  naturally  come  the  foot-fetich- 
ists.  While  glove-fetichism,  which  belongs  to  the  next  group 
of  object- fetichism,  seldom  takes  the  place  of  hand-fetichism,  we 
find  shoe-  and  boot-  fetichism,  of  which  there  are  innumerable 
cases  occurring  everywhere,  taking  the  place  of  enthusiasm  for 
the  naked  female  foot.  There  are  only  here  and  there  traces  of 
the  latter  enthusiasm,  and  these  are  scarcely  pathological.  Tt  is 
easy  to  see  the  reason  for  this.  The  female  hand  is  usually  seen 
uncovered ;  the  foot,  covered.  Thus  the  early  associations 
which  determine  the  direction  of  the  vita  sexualis  are  naturally 
connected  with  the  naked  hand,  but  with  the  covered  foot. 

Shoe-fetichism  also  finds  its  place  in  the  following  group 
of  dress-fetichism  ;    however,   on  account   of  its  demonstrable 

1  This  is  also  sexual  hyperesthesia.  Any  intense  excitement  affects  the  sexual 
sphere  (Binet's  "dynamogenie  g6nerale").  Concerning  this,  Dr.  Moll  communicates  the 
following  case:  "A  similar  thing  is  described  by  Mr.  E.,  aged  27;  merchant.  While  at 
school,  and  afterward,  he  often  had  ejaculation  with  pleasurable  feeling  when  he  was 
seized  with  a  feeling  of  intense  anxiety.  Besides,  almost  every  other  physical  or  mental 
pain  exerted  a  similar  influence.  E.,  as  he  states,  has  a  normal  sexual  instinct,  but  suffers 
with  nervous  impotence." 

11 


162  PSYCHOPATHIA   SEXUALIS. 

masochistic  character  in  the  majority  of  cases,  it  has  been,  for 
the  most  part,  described  already  (p.  123  et  seq.). 

Besides  the  eyes,  hand,  and  foot,  the  mouth  and  ears  often 
play  the  role  of  a  fetich.  Among  others,  Moll  {op.  cit.)  men- 
tions such  cases.  (Comp.  also  Belot's  romance,  "  La  Bouche  de 
Madame  X.,"  which,  B.  states,  rests  upon  actual  observation.) 

The  following  remarkable  case  came  under  my  personal 
observation : — 

Case  77.  A  gentleman  of  very  bad  heredity  consulted  me  concern- 
ing impotence  that  was  driving  him  almost  to  despair.  While  he  was 
young,  his  fetich  was  women  of  plump  form.  He  married  such  a  lady, 
and  was  happy  and  potent  with  her.  After  a  few  months  the  lady  fell 
very  ill,  and  lost  much  flesh.  When,  one  day,  he  tried  to  resume  his 
marital  duty,  he  was  absolutely  impotent,.and  remained  so.  If,  however, 
he  attempted  coitus  with  plump  women,  he  was  perfectly  potent. 

Even  bodily  defects  may  become  fetiches. 

Descartes,  who  himself  ("  Traite  des  Passions,"  cxxxvi)  expresses 
some  opinions  concerning  the  origin  of  peculiar  affections  in  associations 
of  ideas,  was  always  partial  to  cross-eyed  women,  because  the  object  of 
his  first  love  had  such  a  defect.     (Binet,  op.  cit.) 

Lydston  ("A  Lecture  on  Sexual  Perversion,"  Chicago,  1890 x)  reports 
the  case  of  a  man  who  had  a  love-affair  with  a  woman  whose  right  lower 
extremity  had  been  amputated.  After  separation  from  her,  he  searched 
for  other  women  with  a  like  defect.2 — A  negative  fetich. 

When  the  part  of  the  female  body  forming  the  fetich  is 
capable  of  removal,  like  the  hair,  the  most  extravagant  acts 
may  be  performed.  Therefore,  hair-fetichists  form  an  in- 
teresting and  forensically-important  category.  While  such 
admirers  of  female  hair  are  probably  not  infrequent  within 
physiological  limits,  and  possibly  various  senses  (sight,  smell, 
and  hearing,  through  crepitant  sounds, — and  certainly  touch, 
just  as  with  velvet-  and  silk-  fetichists,  v.  infra)  are  thus  excited 
with  an  accompaniment  of  lustful  feeling ;  yet,  a  series  of 
similar  pathological  cases  has  also  been  observed,  in  which  the 
hair-fetichism  had  become  an  overpowering  impulse,  and  driven 

i  Pbila.  Med.  and  Surg.  Rep.,  Sept.  7,  1889. 

2  This  case  was  originally  reported  by  Dr.  A.  R.  Reynolds,  Chicago  (Western  Med. 
Reporter,  Nov.,  1888). 


FETICHISM.  163 

the  individuals  to  commit  crimes.1, 2     These  form  the  group  of 
hair-despoilers. 

Case  78.  A  hair-despoiler.  P.,  aged  40,  artistic  locksmith,  single. 
His  father  was  temporarily  insane,  and  his  mother  was  very  nervous. 
He  developed  well,  arid  was  intelligent ;  but  he  was  early  affected  with 
tics  and  imperative  ideas.  He  had  never  masturbated.  He  loved  pla- 
tonically,  and  often  busied  himself  with  matrimonial  plans.  He  had 
coitus  infrequently  with  prostitutes,  but  never  felt  satisfied  with  such 
intercourse — rather,  disgusted.  Three  years  ago  he  was  overtaken  by 
misfortune  (financial  ruin),  and,  besides,  he  had  a  febrile  disease,  with 
delirium.  These  things  had  a  very  bad  effect  on  his  hereditarily-pre- 
disposed nervous  system.  On  August  28,  1889,  P.  was  arrested  at  the 
Trocadero,  in  Paris,  in  flagranti,  as  he  forcibly  cut  off  a  young  girl's 
hair.  He  was  arrested  with  the  hair  in  his  hand  and  a  pair  of  shears  in 
his  pocket.  He  excused  himself  on  the  ground  of  momentary  mental 
confusion  and  an  unfortunate,  irresistible  passion ;  he  confessed  that  he 
had  ten  times  cut  off  hair,  which  he  took  great  delight  in  keeping  at 
home.  On  searching  his  home,  sixty-five  switches  and  tresses  of  hair 
were  found,  assorted  in  packets.  P.  had  already  been  once  arrested,  on 
December  15,  1886,  under  similar  circumstances,  but  was  released  for 
lack  of  evidence. 

P.  states  that,  for  the  last  three  years,  when  he  is  alone  in  his  room 
at  night,  he  feels  ill,  anxious,  excited,  and  dizzy,  and  then  is  troubled  by 
the  impulse  to  touch  female  hair.  When  it  happened  that  he  could  act- 
ually take  a  young  girl's  hair  in  his  hand,  he  felt  intensely  excited  sexu- 
ally, and  had  erection  and  ejaculation  without  touching  the  girl  in  any 

1  Moll  (op.  eit.,  p.  131)  reports  :  "  A  man,  X.,  becomes  intensely  excited  sexually 
whenever  he  sees  a  woman  with  the  hair  in  a  braid  ;  loose  hair,  no  matter  how  beautiful, 
cannot  produce  this  effect." 

Of  course,  it  is  not  justifiable  to  consider  all  hair-despoilers  fetichists.  for  in  a  few 
cases  such  acts  are  done  for  the  purpose  of  gain, — i.e.,  the  stolen  hair  is  not  a  fetich. 

2  Magnan  (Arch,  de  Neurologie,  vol.  xxxiii,  No,  69, 1892)  gives  the  details  of  a  case 
of  sexual  perversion  in  a  degenerate  individual,  where  the  elements  of  fetichism  and  sadism 
were  combined,  audfaute  de  mieux  the  sadistic  impulse  found  satisfaction  in  self-mutilation. 
The  perverse  impulse  began  at  the  age  of  six ;  the  sight  of  a  boy  or  girl  with  a  delicate, 
white  skin  awakened  in  him  sexual  appetite,  with  a  desire  to  bite  and  eat  a  piece  of  the 
skin.  While  caressing  a  horse,  the  impulse  to  bite  the  soft  skin  of  its  nostrils  arose,  and 
afterward  Jhe  memory  of  this  became  associated  with  the  act  of  onanism.  Later,  he  began 
to  prick  himself  with  pins,  knives,  etc.,  while  masturbating.  The  desire  to  bite  and  eat 
skin  was  also  provoked  by  the  sight  of  shining  blades,  like  those  of  scissors.  He  was 
always  able  to  resist  the  impulse  to  attack  young  girls  :  but  the  struggle  was  hard,  and  for 
eight  months  he  hesitated  before  venting  his  passion  on  his  own  person.  He  was  finally 
arrested  in  the  act  of  cutting  a  large  piece  of  6kin  from  his  arm  with  scissors.  Asked  the 
motive  of  his  self-mutilation,  he  stated  that  for  several  hours  he  had  been  following  a  young 
girl  who  had  a  fine,  white  skin,  and  was  burning  with  desire  to  cut  out  a  piece  of  it  and  eat 
it.  Ou  his  person  there  were  many  scars  of  previous  mutilations.  The  impulse  was  devoid 
of  natural  sexual  desire.     Chewing  the  piece  of  skin  provoked  ejaculation. — Tbans. 


164  PSYCHOPATHIA   SEXUALIS. 

other  way.  On  reaching  home,  he  would  feel  ashamed  of  what  had  taken 
place  ;  but  the  wish  to  possess  hair,  always  accompanied  by  great  sensual 
pleasure,  became  more  and  more  powerful  in  him.  He  wondered  that  pre- 
viously, even  in  the  most  intimate  intercourse  with  women,  he  had  ex- 
perienced no  such  feeling.  One  evening  he  could  not  resist  the  impulse 
to  cut  off  a  girl's  hair.  With  the  hair  in  his  hand,  at  home,  the  sensual 
process  was  repeated.  He  was  forced  to  rub  his  body  with  the  hair  and 
envelop  his  genitals  in  it.  Finally,  quite  exhausted,  he  grew  ashamed, 
and  could  not  trust  himself  to  go  out  for  several  days.  After  months  of 
rest  he  was  again  impelled  to  possess  himself  of  female  hair,  indifferent  as 
to  whose  it  might  be.  If  he  attained  his  end,  he  felt  himself  possessed  by 
a  supernatural  power  and  unable  to  give  up  his  booty.  If  he  could  not 
attain  the  object  of  his  desire,  he  became  greatly  depressed,  hurried  home, 
and  there  reveled  in  his  collection  of  hair.  He  combed  and  fondled  it,  and 
thus  had  intense  orgasm,  satisfying  himself  by  masturbation.  Hair  ex- 
posed in  the  cases  of  hair-dressers  made  no  impression  on  him ;  it  required 
hair  hanging  down  from  a  female  head. 

At  the  height  of  his  act,  he  states,  he  is  in  such  a  state  of  excite- 
ment that  he  has  only  imperfect  apperception  and  subsequent  memory  of 
what  he  does.  When  he  touches  the  hair  with  the  shears  he  has  erection, 
and,  at  the  instant  of  cutting  it  off,  ejaculation.  Since  his  misfortune, 
about  three  years  ago,  he  states  that  he  has  had  weakness  of  memory,  is 
easily  exhausted  mentally,  and  has  been  troubled  by  sleeplessness  and 
night-terrors.     P.  deeply  regrets  his  crime. 

Not  only  hair,  but  a  number  of  hair-pins,  ribbons,  and  other  articles 
of  the  feminine  toilet,  were  found  in  his  possession,  which  he  had  had 
presented  to  him.  He  had  always  had  an  actual  mania  for  collecting 
such  things,  as  well  as  newspapers,  pieces  of  wood,  and  other  worthless 
trash,  which  he  would  never  give  up.  He  also  had  a  strange  and,  to  him, 
inexplicable  fear  of  passing" a  certain  street;  if  he  ever  tried  it,  it  made 
him  ill. 

The  opinion  (medico-legal)  showed  him  to  be  hereditarily  predis- 
posed, and  proved  the  imperative,  impulsive,  and  decidedly  involuntary 
character  of  the  criminal  acts,  which  had  the  significance  of  an  impera- 
tive act,  induced  by  an  imperative  idea,  with  an  accompaniment  of  over- 
powering abnormal  sexual  feeling.  Pardon ;  asylum  for  insane.  ( Voisin, 
Socquet,  Motet,  Annales  d'hygiene,  April,  1890.) 

Following  this  case,  is  a  similar  one  which  also  deserves 
attention  ;  for  it  has  been  well  studied,  and  may  be  called  almost 
classical;  and,  too,  it  places  the  fetich,  as  well  as  the  original 
associative  awakening  of  the  idea,  in  a  clear  light : — 

Case  T9.  A  hair-despoiler.  E.,  aged  25.  Maternal  aunt,  epileptic; 
brother  had  convulsions.     E.  says  he  was  fairly  healthy  as  a  child,  and 


tfETICHlSM.  165 

learned  quite  easily.  At  the  age  of  fifteen  he  had  a  sensual  feeling  of 
pleasure,  with  erection,  at  the  sight  of  one  of  the  village  beauties  combing 
her  hair.  Until  that  time  persons  of  the  opposite  sex  had  made  no  impres- 
sion on  him.  Two  months  later,  in  Paris,  the  sight  of  young  girls  with 
their  hair  flowing  down  over  their  shoulders  always  excited  him  intensely. 
One  day  he  could  not  resist  an  opportunity  to  twist  a  }Oung  girl's  hair  in 
his  fingers.  For  this  he  was  arrested  and  sentenced  to  imprisonment  for 
three  months.  After  that  he  served  five  years  as  a  soldier.  During  this 
time  hair  was  not  dangerous  for  him,  though  also  not  very  accessible  ;  but 
he  dreamed  sometimes  of  female  heads  with  the  hair  braided  or  flowing. 
Occasional  coitus  with  women,  but  without  having  their  hair  effective  as 
a  fetich.  Once  more  in  Paris,  he  again  dreamed  as  before,  and  became 
greatly  excited  by  female  hair.  He  never  dreamed  about  the  whole  form 
of  a  woman,  only  of  heads  with  braids  of  hair.  His  sexual  excitement 
due  to  this  fetich  had  become  so  intense  of  late  that  he  had  resorted  to 
masturbation.  The  idea  of  touching  female  hair,  or,  better,  of  possessing 
it  to  masturbate  while  handling  it,  grew  more  and  more  powerful.  .Of  late, 
when  he  had  female  hair  in  his  fingers,  ejaculation  was  induced.  One 
day  he  succeeded  in  cutting  hair,  about  25  'centimetres  long,  from  three 
little  girls  in  the  street,  and  keeping  it  in  his  possession,  when  he  was 
arrested  in  a  fourth  attempt.  Deep  regret  and  shame.  He  was  not  sen- 
tenced. Since  spending  some  time  in  the  asylum,  he  has  so  far  improved 
that  female  hair  no  longer  excites  him.  Set  at  liberty,  he  thought  of 
going  to  his  native  place,  where  the  women  wear  their  hair  done  up. 
(Magnan,  Archiv.  de  Vanthropol.  criryinelle,  v,  Nr.  28.) 

A  third  case  is  the  following,  which  is  likewise  suited  to 
illustrate  the  psychopathic  nature  of  such  phenomena ;  and  the 
remarkable  means  which  induced  a  cure  are  worthy  of  note : — 

Case  80.  Hair-fetichism.  Mr.  X.,  between  thirty  and  forty  years 
old  ;  from  the  higher  class  of  society  ;  single.  He  says  that  he  comes  of 
a  healthy  family,  but  from  childhood  has  been  nervous,  vacillating,  and 
peculiar;  that  since  his  eighth  year  he  has  been  powerfully  attracted 
by  female  hair.  This  was  particularly  true  in  the  case  of  jToung  girls. 
When  he  was  nine  years  old,  a  girl  of  thirteen  seduced  him.  He  did  not 
understand  it,  and  was  not  at  all  excited.  A  twelve-year-old  sister  of 
this  girl  also  courted,  kissed,  and  hugged  him.  He  allowed  this  quietly, 
because  this  girl's  hair  pleased  him  so  well.  When  about  ten  years  old,  he 
began  to  have  sensual  feelings  at  the  sight  of  female  hair  that  pleased  him. 
Gradually  these  feelings  occurred  spontaneously,  and  memory-pictures- 
of  girls'  hair  were  always  immediately  associated  with  them.  At  the  age 
of  eleven  he  was  taught  to  masturbate  by  school-mates.  The  associative 
connection  of  sexual  feelings  and  a  fetichistic  idea  was  already  established, 
and  always  appeared  when  the  patient  indulged  in  evil  practices  with  his 


166  PSYCHOPATHIA    SEXUALIS. 

companions.  With  advancing  years,  the  fetich  grew  more  and  more  power- 
ful. Even  false  hair  began  to  excite  him,  but  he  always  preferred  natural 
hair.  When  he  could  touch  or  kiss  it,  he  was  perfectly  happy.  He 
wrote  essays  and  poems  on  the  beauty  of  female  hair ;  he  sketched  heads 
of  hair  and  masturbated.  After  his  fourteenth  year  he  became  so  power- 
fully excited  by  his  fetich  that  he  had  violent  erections.  In  contrast  with 
his  early  taste  while  a  boy,  he  was  now  charmed  only  by  luxuriant,  thick 
black  hair.  He  experienced  intense  desire  to  kiss  such  hair,  particularly 
to  suck  it.  To  touch  such  hair  afforded  him  but  little  satisfaction ;  he 
obtained  much  more  pleasure  in  looking  at  it,  but  particularly  in  kissing 
and  sucking  it.  If  this  were  impossible,  he  would  become  unhappy,  even 
to  the  extent  of  taedium  vitae.  Then  he  would  attempt  to  relieve  himself, 
imagining  fantastic  "  hair-adventures  "  and  masturbating.  Not  infre- 
quently, in  the  street  and  in  crowds,  he  could  not  keep  from  imprinting 
a  kiss  on  ladies'  heads.  He  would  then  hurry  home  to  masturbate. 
Sometimes  he  could  resist  this  impulse ;  but  it  was  then  necessary  for 
him,  filled  with  feelings  of  fear,  to  run  away  as  quickly  as  possible,  in 
order  to  escape  the  domination  of  his  fetich.  He  was  only  once  im- 
pelled to  cut  off  a  girl's  hair  in  a  crowd.  In  the  act  he  was  seized  with 
fear,  and  was  not  successful  with  his  pocket-knife;  and,  by  flight,  he  nar- 
rowly escaped  detection. 

When  he  became  mature,  he  attempted  to  satisfy  himself  in  coitus 
with  puellis.  He  induced  powerful  erection  by  kissing  the  hair,  but  could 
not  induce  ejaculation.  Therefore,  he  was  unsatisfied  by  coitus.  At  the 
same  time,  his  favorite  idea  was  coitus  with  kissing  of  hair ;  but  even 
this  did  not  satisfy  him,  because  it  did  not  induce  ejaculation.  Faute 
de  mieux,  he  once  stole  the  combings  of  a  lady's  hair,  put  it  in  his  mouth, 
and  masturbated  while  calling  its  owner  up  in  imagination.  In  the  dark 
a  woman  could  not  interest  him,  because  he  could  not  then  see  her  hair. 
Flowing  hair  also  had  no  charm  for  him ;  nor  did  the  hair  about  the 
genitals.  His  erotic  dreams  were  all  about  hair.  Of  late  the  patient 
had  become  so  excited  that  he  had  a  kind  of  satyriasis.  He  was  incapa- 
ble of  business,  and  felt  so  unhappy  that  he  sought  to  drown  his  sorrow 
in  alcohol.  He  drank  large  quantities,  had  alcoholic  delirium,  an  attack 
of  alcoholic  epilepsy,  and  required  hospital  treatment.  After  the  intoxi- 
cation had  passed  away,  under  appropriate  treatment,  the  sexual  excite- 
ment soon  disappeared ;  and  when  the  patient  was  discharged,  he  was 
freed  from  his  fetichistic  idea,  save  for  its  occasional  occurrence  in 
dreams.  The  physical  examination  showed  normal  genitals  and  no 
degenerative  signs  whatever. 

Such  cases  of  hair-fetichism,  which  lead  to  attacks  on 
female  hair,  seem  to  occur  everywhere,  from  time  to  time.  In 
November,  1890,  according  to  reports  in  American  newspapers, 


PETICHISM.  167 

several  cities  in  the  United  States  were  troubled  by  such  hair- 
despoilers. 

(b)  The  Fetich  is  an  Article  of  Female  Attire. — The  great 
importance  of  adornment,  ornament,  and  dress,  in  the  normal 
vita  sexualis  of  man,  is  very  generally  recognized.  Culture  and 
fashion1  have,  to  a  certain  extent,  endowed  woman  with  arti- 
ficial sexual  characteristics,  the  removal  of  which,  when  woman 
is  seen  unattired,  in  spite  of  the  normal  sensual  effect  of  this 
sight,  may  exert  an  opposite  influence.2  It  should  not  be  over- 
looked that  female  dress  often  shows  a  tendency  to  emphasize 
and  exaggerate  certain  sexual  peculiarities,— secondary  sexual 
characteristics  (bosom,  waist,  hips).  In  most  individuals  the 
sexual  instinct  awakes  long  before  there  is  any  possibility  or  op- 
portunity of  intimate  intercourse,  and  the  early  desires  of  youth 
are  concerned  with  the  ordinary  appearance  of  the  attired  female 
form.  Thus  it  happens  that  not  infrequently,  at  the  beginning 
of  the  vita  sexualis,  ideas  of  the  persons  exerting  sexual  charms 
and  ideas  of  their  attire  become  associated.  This  association 
may  be  lasting — the  attired  woman  may  be  always  preferred — 
if  the  individuals  dominated  by  this  perversion  do  not  in  other 
respects  attain  to  a  normal  vita  sexualis,  and  find  gratification  in 
natural  charms. 

In  psychopathic  individuals,  sexually  hyperaesthetic,  as  a 
result  of  this,  it  actually  happens  that  the  dressed  woman  is 
always  preferred  to  the  nude  female  form.  It  may  be  recalled 
that  in  Case  48  the  woman  was  not  to  take  off  a  garment,  and 


1  The  frequent  changes  of  style  of  dress  which  fashion  dictates  may  be  referred  to  a 
physiological  law.  The  reaction  of  the  nervous  system  to  a  constant  stimulus  diminishes 
in  proportion  to  the  duration  of  the  action  of  the  stimulus.  Constant  association  with 
nudity  removes  its  power  to  excite  sexually.  Owing  to  this,  the  savage  endeavors  to  attract 
attention  by  changing  his  physical  peculiarities ;  he  dresses  his  hair  in  some  remarkable 
way,  or  paints  his  body  ;  then  he  tattooes  his  skin,  or  performs  striking  self-mutilation,  such 
as  half-castration  and  circumcision  (comp.  Westermarck,  op.  cit.,  p.  205).  Finally,  muti- 
lation is  replaced  by  movable  appendages,  upon  which  ornaments  are  worn  ;  and  thus  there 
is  afforded  opportunity  for  change,  in  obedience  to  the  unconscious  physiological  require- 
ment, which  is  called  a  "  taste  for  change."  Undoubtedly,  woman's  desire  for  changes  of 
fashion  is  primarily  dependent  upon  man's  desire  to  be  pleased  ;  and  her  function  in  this 
direction  has  certainly  been  transferred  from  him  to  her  by  civilization  (comp.  p.  16). 
— Trans. 

2  Comp.  Goethe's  remarks  about  his  adventure  in  Geneva  ("  Briefe  aus  der  Schweiz," 
1.  Abtheil.,  Schluss). 


168  PSYCHOPATHIA   SEXUALIS. 

that  in  Case  51,  equus  eroticus,  the  woman  was  preferred  dressed. 
In  Case  89,  of  the  sixth  edition, — that  of  a  man  manifesting 
contrary  sexuality, — the  same  preference  is  expressed. 

Dr.  Moll  (op.  cit.y  mentions  a  patient  who  could  not  per- 
form coitus  with  puella  nuda ;  the  woman  had  to  have  on  a 
chemise,  at  least.  The  same  author  (op.  cit.,  p.  129)  mentions 
a  man  affected  with  contrary  sexuality,  who  was  subject  to  the 
same  dress-fetichism. 

The  reason  for  this  phenomenon  is  apparently  to  be  found 
in  the  mental  onanism  of  such  individuals.  In  seeing  innu- 
merable clothed  forms,  they  have  cultivated  desires  before  seeing 
nudity.1 

A  more  marked  form  of  dress-fetichism  is  that  in  which, 
instead  of  the  dressed  woman,  a  certain  kind  of  attire  becomes 
a  fetich.  One  can  understand  how,  with  an  intense  and  early 
sexual  impression,  combined  with  the  idea  of  a  particular  gar- 
ment on  the  woman,  in  hyperaesthetic  individuals,  a  very  intense 
interest  in  this  garment  might  be  developed. 

Hammond  (op.  cit.)  reports  the  following  case,  taken  from 
Roubaud  ("  Traite  de  l'impuissance,"  Paris) : — 

Case  81.  X.,  son  of  a  general.  He  was  raised  in  the  country.  At 
the  age  of  fourteen  he  was  initiated  into  the  jo}-s  of  love  by  a  3roung 
lady.  This  lady  was  a  blonde,  and  wore  her  hair  in  ringlets;  and,  in 
order  to  avoid  detection  in  sexual  intercourse  with  her  3roung  lover,  she 
always  wore  her  usual  clothing, — gaiters,  a  corset,  and  a  silk  dress. 

When  his  studies  were  completed,  and  he  was  sent  to  a  garrison 
where  he  could  enjoy  freedom,  he  found  that  his  sexual  desire  could  be 
excited  only  under  certain  conditions.  A  brunette  could  not  excite  him 
in  the  least,  and  a  wqman  in  night-clothes  could  stifle  every  bit  of  love 
in  him.  In  order  to  awaken  his  desire,  a  woman  had  to  be  a  blonde,  and 
wear  gaiters,  a  corset,  and  a  silk  dress, — in  short,  she  had  to  be  dressed 
like  the  lady  who  had  first  awakened  his  sexual  desire.  He  was  always 
compelled  to  give  up  thoughts  of  matrimony,  because  he  knew  he  would 
be  unable  to  fulfill  his  marital  duty  with  a  woman  in  night-clothes. 

Hammond  reports  another  case  where  coitus  maritalis  could  be 
performed  only  by  the  help  of  a  certain  costume;  and  Dr.  Moll  mentions 

1  The  fact  that  the  partly-veiled  form  is  often  more  charming  than  when  it  is  per- 
fectly nude,  is,  as  far  as  object  goes,  similar,  but  quite  different  psychically.  This  depends 
upon  the  effect  of  contrast  and  expectation,  which  are  common  phenomena,  and  in  no 
sense  pathological. 


FETICHISM.  169 

several  similar  cases  in  individuals  of  hetero-  and  homo-  sexuality.  The 
cause  may  often  be  shown  to  be  an  early  association,  and  such  may 
always  be  assumed.  It  is  only  in  this  way  that  one  can  explain  why  a 
certain  costume  cannot  be  resisted  by  such  individuals,  no  matter  what 
person  wears  the  fetich.  Thus  one  can  understand  why,  as  Cofflgnon 
(op.  cit.)  relates,  men  at  brothels  demand  that  the  women  with  whom 
they  are  concerned  put  on  certain  costumes,  such  as  that  of  a  ballet- 
dancer,  cr  nun,  etc. ;  and  why  these  houses  are  furnished  with  a  com- 
plete wardrobe  for  such  purposes. 

Binet  (op.  cit.)  relates  the  case  of  a  judge  who  was  exclusively  in 
love  with  Italian  girls  who  came  to  Paris  as  artists'  models,  and  their 
peculiar  costume.  The  cause  was  here  demonstrably  an  impression  made 
at  the  time  of  the  awakening  of  the  sexual  instinct. 

A  third  form  of  dress- fetichism,  having  a  much  higher 
degree  of  pathological  significance,  is  by  far  the  most  frequent. 
In  this  form  it  is  no  longer  the  woman  herself,  dressed,  or  even 
dressed  in  a  particular  fashion,  that  constitutes  the  principal 
sexual  stimulus,  but  the  sexual  interest  is  so  concentrated  on 
some  certain  article  of  female  attire  that  the  lustful  idea  of  this 
object  is  entirely  separated  from  the  idea  of  woman,  and  thus 
obtains  an  independent  value.  This  is  the  real  domain  of  dress- 
fetichism,*  where  an  inanimate  object — an  isolated  article  of 
wearing-apparel — is  alone  used  for  the  excitation  and  satisfaction 
of  the  sexual  instinct.  This  third  form  of  dress-fetichism  is 
also  the  one  that  is  important  forensically. 

In  a  large  number  of  these  cases  the  fetiches  are  articles 
of  female  underwear,  which,  owing  to  their  private  use,  are 
suited  to  occasion  such  associations. 

Case  82.  K.,  aged  45,  shoemaker,  is  reported  to  be  without  hereditary 
taint.  He  is  peculiar,  and  has  small  mental  endowment.  He  is  of  mascu- 
line habitus  and  without  signs  of  degeneration.  Previously  blameless 
in  conduct,  on  the  evening  of  July  5,  1876,  he  was  detected  taking  stolen 
female  under-garments  from  a  place  of  concealment.  There  were  found 
with  him  about  three  hundred  articles  of  the  female  toilet,  among  them, 
besides  chemises  and  drawers,  night-caps,  garters,  and  a  female  doll. 
When  arrested  he  was  wearing  a  chemise.  Since  his  thirteenth  year  he 
had  been  a  slave  to  an  impulse  to  steal  women's  linen ;  but,  after  his  first 
punishment  for  it,  he  had  become  very  careful,  and  stolen  with  refinement 
and  success.  When  this  longing  came  over  him,  he  would  grow  anxious, 
and  his  head  would  become  heavy.    Then  he  could  not  resist  the  impulse, 


170  PSTCHOPATHIA   SEXUALIS. 

cost  what  it  might.  He  was  indifferent  to  the  source  of  the  articles.  At 
night,  on  going  to  bed,  he  would  put  on  the  stolen  clothing  and  create 
beautiful  women  in  imagination,  thus  inducing  pleasurable  feeling  and 
ejaculation.  This  was  apparently  the  motive  of  his  thefts ;  at  least,  he 
had  never  disposed  of  any  of  the  articles,  but  had  hidden  them  here  and 
there. 

He  declared  that,  earlier  in  his  life,  he  had  indulged  in  normal  sexual 
intercourse  with  women.  He  denied  onanism,  pederasty,  and  other  sexual 
acts.  He  said  he  was  engaged  at  twenty-five,  but  the  engagement  was 
broken  through  no  fault  of  his.  He  was  incapable  of  insight  into  the 
abnormality  of  his  condition  and  the  wrong  of  his  acts.  (Passow,  Vier- 
teljahrsschrift  f.  ger.  Medic,  N.  F.  xxviii,  p.  61 ;  Krauss,  "  Psychologie 
des  Yerbrechens,"  1884,  p.  190.) 

Hammond  {op.  cit.)  reports  a  case  of  passionate  interest  in 
single  articles  of  female  wearing-apparel.  Here,  also,  the 
patient's  pleasure  consisted  in  wearing  a  corset  and  other 
female  garments  (without  any  traces  of  contrary  sexual 
instinct).  The  pain  of  tight  lacing,  experienced  by  himself 
or  induced  in  women,  is  a  delight  to  him, — sadistic-masochistic 
element. 

A  case  probably  belonging  here  is  one  reported  by  Diez 
("Der  Selbstmord,"  1838,  p.  24),  where  a  young  man*could  not 
resist  the  impulse  to  tear  female  linen.  While  tearing  it,  he 
always  had  ejaculation. 

A  combination  of  fetichism  with  an  impulse  to  destroy  the 
fetich  (in  a  certain  sense,  sadism  with  inanimate  objects)  seems 
to  occur  quite  frequently  (comp.  Case  93). 

An  article  of  dress,  which,  though  it  has  not  really  a  pri- 
vate character,  by  its  material  and  color,  as  well  as  by  the  place 
where  it  is  worn,  recalls  under-garments,  and  hence  has  sexual 
relations,  is  the  apron  (comp.  also  the  metonymic  use  of  the 
word  "  apron  "  for  "  petticoat "  in  the  saying,  "  To  chase  every 
apron,"  etc.).     This  explains  the  following  case : — 

Case  83.  C,  aged  37  ;  of  a  badly  tainted  family ;  of  small  mental  en- 
dowment ;  plagiocephalic.  At  fifteen  his  attention  was  attracted  b}r  aprons 
hung  out  to  dry.  He  bound  them  about  himself  and  masturbated  behind 
the  fence.  From  that  time  he  could  not  see  aprons  without  repeating  the 
act.  If  any  one — no  matter  whether  man  or  woman — with  an  apron  on 
came  near  him,  he  was  compelled  to  run  after  the  person.    In  order  to  free 


PETICHISM.  171 

him  from  this  constant  stealing  of  aprons,  he  was  sent  as  a  marine  in  his 
sixteenth  year.  In  this  calling  he  saw  no  aprons,  and  had  continual  rest. 
When,  at  nineteen,  he  returned  home,  he  was  again  compelled  to  steal 
aprons,  and,  as  a  result,  got  into  serious  complications,  and  was  several 
times  locked  up.  He  sought  to  free  himself  of  his  weakness  by  a 
sojourn  of  several  years  in  a  cloister.  When  he  came  out,  he  was  just 
as  bad  as  before.  As  a  result  of  a  new  theft,  he  underwent  a  medico-legal 
examination,  and  was  committed  to  an  asylum.  He  never  stole  anything 
but  aprons.  It  was  a  pleasure  to  him  to  revel  in  the  memory  of  the  first 
apron  he  ever  stole.  His  dreams  were  filled  with  aprons.  He  occasion- 
ally used  the  memory  of  his  thefts  to  make  coitus  possible,  or  for  mastur- 
bation.    (Charcot  and  Magnan,  Arch,  de  neurolog.,  1882,  Nr.  12.) 

In  a  case  reported  by  Lombroso  ("  Amori  anomali  precoci  nei 
pazzi,"  Arch,  di  psich.,  1883,  p.  17),  analogous  to  those  of  this  series,  a 
boy  of  very  bad  heredity,  at  the  age  of  four,  had  erections  and  great 
sexual  excitement  at  the  sight  of  white  garments,  particularly  under- 
clothing. He  was  lustfully  excited  by  handling  and  crumpling  them.  At 
the  age  of  ten  he  began  to  masturbate  at  the  sight  of  white,,  starched  linen. 
He  seems  to  have  been  affected  with  moral  insanity,  and  was  executed 
for  murder. 

The  following  case  of  petticoat-fetichism  is  combined  with 
peculiar  circumstances : — 

Case  84.  Z.,  aged  35 ;  official ;  the  only  child  of  a  nervous  mother 
and  healthy  father.  From  childhood  he  was  "  nervous,"  and  at  the  con- 
sultation his  neuropathic  e3Tes,  delicate,  slender  body,  fine  features,  very 
thin  voice,  and  sparse  growth  of  beard  attracted  attention.  The  patient 
presents  nothing  abnormal  except  symptoms  of  slight  neurasthenia. 
Genitals  and  sexual  functions  normal.  Patient  states  that  he  has  only 
masturbated  four  or  five  times,  and  that  when  he  was  very-young.  As 
early  as  at  the  age  of  thirteen,  the  patient  was  powerfully  excited  sex- 
ually by  the  sight  of  wet  female  dresses ;  while  the  same  dresses,  when 
dry,  had  no  effect  upon  him.  His  greatest  delight  was  to  look  at  women 
with  wet  garments  in  the  rain.  If  he  met  a  woman  having  a  pleasing 
face  under  such  circumstances,  he  experienced  an  intense  feeling  of  lust- 
ful pleasure,  had  erection,  and  felt  impelled  to  perform  coitus.  He  states 
that  he  has  never  had  any  desire  to  wet  female  dresses  or  to  throw  water 
on  women.     He  can  give  no  explanation  of  the  origin  of  his  peculiarity. 

It  is  possible  that,  in  this  case,  the  sexual  instinct  was  first  awak- 
ened by  the  sight  of  a  woman  as  she  exposed  her  charms  by  raising  her 
skirts  in  wet  weather.  The  obscure  instinct,  not  yet  conscious  of  its 
object,  then  became  directed  to  the  wet  garments,  as  in  other  cases. 

Lovers  of  female  handkerchiefs  are  frequent,  and,  there- 


172  PSYCHOPATHIA   SEXUALlS. 

fore,  important  forensically.  As  to  the  frequency  of  handker- 
chief-fetichism,  it  may  be  remarked  that  the  handkerchief  is  the 
one  article  of  feminine  attire  which,  outside  of  intimate  associa- 
tion, is  most  frequently  displayed,  and  which,  with  its  warmth 
from  the  person  and  specific  odors,  may  by  accident  fall  into  the 
hands  of  others.  The  frequency  of  early  association  of  lustful 
feelings  with  the  idea  of  a  handkerchief,  which  may  always  be 
presumed  to  have  occurred  in  such  cases  of  fetichism,  probably 
is  due  to  this. 

Case  85.  A  baker's  assistant,  aged  32,  single,  previously  of  good 
repute,  was  discovered  stealing  a  handkerchief  from  a  lady.  In  sincere 
remorse,  he  confessed  that  he  had. stolen  from  eighty  to  ninety  such  hand- 
kerchiefs. He  had  cared  only  for  handkerchiefs,  and,  indeed,  only  for 
those  belonging  to  young  women  attractive  to  him.  In  his  outward  appear- 
ance the  culprit  presents  nothing  peculiar.  He  dresses  himself  with  much 
taste.  His  conduct  is  peculiar,  anxious,  depressed,  and  unmanly,  and  he 
often  lapses  into  whining  and  tears.  Lack  of  self-reliance,  weakness  of 
comprehension,  and  slowness  of  perception  and  reflection,  are  noticeable. 
One  of  his  sisters  is  epileptic.  He  lives  in  good  circumstances ;  was 
never  severely  sick ;  developed  well.  In  relating  his  historj',  he  shows 
weakness  of  memory  and  lack  of  clearness  ;  calculation  is  hard  for  him, 
though  when  young  he  learned  and  comprehended  easily.  His  anxious, 
uncertain  state  of  mind  gives  rise  to  a  suspicion  of  onanism.  The  culprit 
confessed  that  he  had  been  given  to  this  practice  excessively  since  his 
nineteenth  year.  For  some  years,  as  a  result  of  his  vice,  he  had  suffered 
with  depression,  lassitude,  trembling  of  the  limbs,  pain  in  the  back,  and 
disinclination  for  work.  Frequently  a  depressed,  anxious  state  of  mind 
came  over  him,  in  which  he  avoided  people.  He  had  exaggerated,  fan- 
tastic notions  about  the  results  of  sexual  intercourse  with  women,  and 
could  not  bring  himself  to  indulge  in  it.  Of  late,  however,  he  had  thought 
of  marriage.  With  great  remorse  and  in  a  weak-minded  way,  X.  now 
confessed  that  six  months  before,  while  in  a  crowd,  he  became  violently 
excited  sexually  at  the  sight  of  a  pretty  young  girl,  and  was  compelled  to 
crowd  up  against  her.  He  felt  an  impulse  to  compensate  himself- for  the 
want  of  a  more  complete  satisfaction  of  his  sexual  excitement,  by  stealing 
her  handkerchief.  Thereafter,  as  soon  as  he  came  near  attractive  females, 
with  violent  sexual  excitement,  palpitation  of  the  heart,  erection  and 
impetus  coeundi,  the  impulse  would  seize  him  to  crowd  up  against  them 
and,  / aide  de  mieux,  steal  their  handkerchiefs.  Although  the  conscious- 
ness of  his  criminal  act  never  left  him  for  a  moment,  he  was  unable  to 
make  any  resistance  to  the  impulse.  During  the  act  he  felt  an  anxiety 
which  was  in  part  due  to  his  inordinate  sexual  impulse,  and  partly  to  the 


FETICHISM.  173 

fear  of  detection.  The  medico-legal  opinion  rightly  gave  weight  to  the 
congenital  mental  enfeeblement  and  the  pernicious  influence  of  masturba- 
tion, and  referred  the  abnormal  impulses  to  a  perverse  sexual  impulse, 
calling  attention  to  the  presence  of  an  interesting  and  well-known  physio- 
logical connection  between  the  olfactory  and  sexual  senses.  The  inability 
to  resist  the  pathological  impulse  was  recognized.  X.  was  not  punished. 
(Zippe,  Wiener  Med.  Wochenschrift,  1879,  Nr.  23.) 

I  am  indebted  to  the  kindness  of  Dr.  Fritsch,  of  Vienna, 
for  further  facts  concerning  this  handkerchief-fetichist,  who  was 
again  arrested  in  August,  1890,  in  the  act  of  taking  a  handker- 
chief from  a  lady's  pocket : — 

On  searching  his  house,  four  hundred  and  forty -six  ladies'  handker- 
chiefs were  found.  He  stated  that  he  had  burned  besides  two  bundles 
of  them.  In  the  course  of  the  examination,  it  was  further  shown  that 
X.  had  been  punished  with  imprisonment  for  fourteen  days,  in  1883,  for 
stealing  twenty -seven  handkerchiefs,  and  again  with  imprisonment  for 
three  weeks,  in  1886,  for  a  similar  crime.  Concerning  his  relatives,  nothing 
more  could  be  learned  than  that  his  father  was  subject  to  congestions, 
and  that  a  brother's  daughter  was  weak-minded  and  constitutionally  neuro- 
pathic. X.  had  married  in  1879,  and  embarked  in  an  independent  business, 
and  in  1881  he  made  an  assignment.  Soon  after  that,  his  wife,  who  could 
not  live  with  him,  and  with  whom  he  did  not  perform  his  marital  duty 
(denied  by  X.) ,  demanded  a  divorce.  Thereafter  he  lived  as  assistant  baker 
to  his  brother.  He  complained  bitterly  of  an  impulse  for  ladies'  handker- 
chiefs, but  when  opportunity  offered,  unfortunately,  he  could  not  resist  it. 
In  the  act  he  experienced  a  feeling  of  delight,  and  felt  as  if  some  one  were 
forcing  him  to  it.  Sometimes  he  could  restrain  himself,  but,  when  the 
lady  was  pleasing  to  him,  he  yielded  to  the  first  impulse.  He  would  be 
wet  with  sweat,  partly  from  fear  of  detection,  and  partly  on  account  of 
the  impulse  to  perform  the  act.  He  says  he  has  been  sensually  excited, 
by  the  sight  of  handkerchiefs  belonging  to  women,  since  puberty.  He 
cannot  recall  the  exact  circumstances  of  this  fetichistic  association.  The 
sensual  excitement,  occasioned  by  the  sight  of  a  lady  with  a  handkerchief 
hanging  out  of  her  pocket,  had  constantly  increased.  This  had  repeatedly 
caused  erection,  but  never  ejaculation.  After  his  twenty-first  year,  he  says, 
he  had  inclination  to  normal  sexual  indulgence,  and  had  coitus  without 
difficulty  without  ideas  of  handkerchiefs.  With  increasing  fetichism,  the 
appropriation  of  handkerchiefs  had  afforded  him  much  more  satisfaction 
than  coitus.  The  appropriation  of  the  handkerchief  of  a  lady  attractive 
to  him  was  the  same  to  him  as  intercourse  with  her  would  have  been.  In 
the  act  he  had  true  orgasm. 

If  he  couid  not  gain  possession  of  the  handkerchief  he  desired,  he 


174  PSYCHOPATHIA   SEXUALIS. 

would  become  painfully  excited,  tremble,  and  sweat  all  over.  He  kept 
separate  the  handkerchiefs  of  ladies  particularly  pleasing  to  him,  and 
reveled  in  the  sight  of  them,  taking  great  pleasure  in  it.  The  odor  of 
them  also  gave  him  great  delight,  though  he  states  that  it  was  really  the 
odor  peculiar  to  the  linen,  and  not  the  perfume,  which  excited  him  sen- 
sually.    He  had  masturbated  but  very  seldom. 

X.  complained  of  no  physical  ailments  except  occasional  headache 
and  vertigo.  He  greatly  regretted  his  misfortune,  his  abnormal  impulse, — 
the  evil  spirit  that  impelled  him  to  such  criminal  acts.  He  had  but  one 
wish  :  that  some  one  might  help  him.  Objectively  there  are  mild  neuras- 
thenic symptoms,  anomalies  of  the  distribution  of  blood,  and  unequal 
pupils. 

It  was  proved  that  X.  had  committed  his  crimes  in  obedience  to  an 
abnormal,  irresistible  impulse.     Pardon. 

Such  cases  of  handkerchief-fetichism,  where  an  abnormal 
individual  is  driven  to  theft,  are  very  numerous.  They  also 
occur  in  combination  with  contrary  sexuality,  as  is  proved  by 
the  following  case,  which  I  borrow  from  page  125  of  Dr.  Moll's 
frequently-cited  work 1 : — 

Case  86.  Handkerchief-fetichism  in  a  Case  of  Contrary  Sexual 
Instinct. — K.,  aged  38 ;  mechanic ;  a  powerfully  built  man.  He  makes 
numerous  complaints, — weakness  of  the  legs,  pain  in  the  back,  headache, 
want  of  pleasure  in  work,  etc.  The  complaints  give  the  decided  impres- 
sion of  neurasthenia  with  tendency  to  hypochondria.  Only  after  the 
patient  had  been  under  my  treatment  several  months  did  he  state  that  he 
was  also  abnormal  sexually. 

K.  had  never  had  any  inclination  whatever  for  womeji ;  but  hand- 
some men,  on  the  other  hand,  had  a  peculiar  charm  for  him.  Patient 
had  masturbated  frequently  until  he  came  to  me.  He  had  never  prac- 
ticed mutual  onanism  or  pederasty.  He  did  not  think  that  he  would 
have  found  satisfaction  in  this,  because,  in  spite  of  his  preference  for 
men,  an  article  of  white  linen  was  his  chief  charm,  though  the  beauty 
of  its  owner  played  a  role.  The  handkerchiefs  of  handsome  men  particu- 
larly excite  him  sexually.  His  greatest  delight  is  to  masturbate  in  men's 
handkerchiefs.     For  this  reason  he  often  took  his  friend's  handkerchiefs. 

1  On  page  134  (op.  cit.)  Dr.  Moll  writes  concerning  this  impulse  in  hetero-sexual 
individuals  :  "  The  passion  for  handkerchiefs  may  go  so  far  that  the  man  is  entirely  under 
their  control.  A  woman  tells  me  :  '  I  know  a  certain  gentleman,  and  when  I  see  him  at  a 
distance  I  only  need  to  draw  out  my  handkerchief  so  that  it  peeps  out  of  my  pocket,  and  I 
am  certain  that  he  will  follow  me  as  a  dog  follows  its  master.  Go  where  I  please,  this  gen- 
tleman will  follow  me.  He  may  be  riding  in  a  carriage  or  engaged  in  important  business, 
and  yet,  when  he  sees  my  handkerchief  he  drops  everything  in  order  to  follow  me, — i.e.,  my 
handkerchief.' " 


FETICHISM.  175 

In  order  to  save  himself  from  detection,  he  always  left  one  of  his  own 
handkerchiefs  with  his  friend  in  place  of  the  one  he  stole.  In  this  way 
he  sought  to  escape  the  suspicion  of  theft,  by  creating  the  appearance  of 
a  mistake.  Other  articles  of  men's  linen  also  excited  K.  sexually,  but 
not  to  the  extent  handkerchiefs  did. 

K.  had  often  performed  coitus  with  women,  having  erection  and 
ejaculation,  but  without  lustful  pleasure.  There  was  also  nothing  which 
could  stimulate  the  patient  to  the  performance  of  coitus.  Erection  and 
ejaculation  occurred  only  when,  during  the  act,  he  thought  of  a  man's 
handkerchief;  and  this  was  easier  for  the  patient  when  he  took  a  friend's 
handkerchief  with  him,  and  had  it  in  his  hand  during  coitus.  In  accord- 
ance with  his  sexual  perversion,  in  his  nightly  pollutions  with  lustful 
ideas,  men's  linen  played  the  principal  role. 

It  is  possible  that,  in  this  interest  in  (used)  handkerchiefs, 
elements  of  feeling-  in  the  sense  of  masochism,  group  "  c."  are  also 
often  at  work. 

Still  far  more  frequent  than  the  fetichism  of  linen  garments 
is  that  of  women's  shoes.  These  cases  are,  in  fact,  almost 
innumerable,  and  a  great  many  of  them  have  been  scientifically 
studied ;  but  I  have  but  a  few  reports  at  second  hand  of  the 
similar  glove-fetichism  (concerning  the  reason  for  the  relative 
infrequency  of  glove-fetichism,  vide  p.  161). 

In  shoe-fetichism  the  close  relationship  of  the  object  to  the 
feminine  person,  which  explains  linen-fetichism,  is  absolutely 
wanting.  For  this  reason,  and  because  there  is  a  large  number 
of  well-observed  cases  at  hand,  in  which  the  fetichistic  enthusi- 
asm for  the  female  shoe  or  boot  consciously  and  undoubtedly 
arises  from  masochistic  ideas,  an  origin  of  a  masochistic  nature, 
even  when  it  is  concealed,  may  always  be  assumed  in  shoe- 
fetichism,  when,  in  the  concrete  case,  no  other  manner  of  origin 
is  demonstrable.  For  this  reason  the  majority  of  the  cases  of 
shoe-  or  foot-  fetichism  have  been  given  under  "  Masochism." 
There  the  constant  masochistic  character  of  this  form  of  erotic 
fetichism  has  been  sufficiently  demonstrated  by  means  of  tran- 
sitional conditions.  This  presumption  of  the  masochistic  char- 
acter of  shoe-fetichism  is  weakened  and  removed  only  where 
another  accidental  cause  for  an  association  between  sexual 
excitation  and  the  idea  of  women's  shoes — the  occurrence  of 
which  is  quite  improbable  a  priori — is  demonstrable.    In  the 


176  PSYCHOPATHIA   SEXUALIS. 

two  following  cases,  however,  there  is  such   a   demonstrable 
connection : — 

Case  87.  Shoe-feticnism.  Mr.  v.  P.,  of  an  old  and  honorable  fam- 
ily, Pole,  aged  32,  consulted  me,  in  1890,  on  account  of  "  unnaturalness  " 
of  his  vita  sexualis.  He  gave  the  assurance  that  he  came  of  a  perfectly 
healthy  family.  He  had  been  nervous  from  childhood,  and  had  suffered 
with  chorea  minor  at  the  age  of  eleven.  For  ten  years  he  had  suffered 
with  sleeplessness  and  various  neurasthenic  ailments.  From  his  fifteenth 
year  he  had  recognized  the  difference  of  the  sexes  and  been  capable  of 
sexual  excitation.  At  the  age  of  seventeen  he  had  been  seduced  by  a 
French  governess,  but  coitus  was  not  permitted ;  so  that  intense  mutual 
sensual  excitement  (mutual  masturbation)  was  all  that  was  possible.  In 
this  situation  his  attention  was  attracted  by  her  very  elegant  boots. 
They  made  a  very  deep  impression.  His  intercourse  with  this  lewd 
person  lasted  four  months.  During  this  association  her  shoes  became  a 
fetich  for  the  unfortunate  boy.  He  began  to  have  an  interest  in  ladies' 
shoes  in  general,  and  actually  went  about  trying  to  catch  sight  of  ladies 
wearing  pretty  boots.  The  shoe-fetichism  gained  great  power  over  his 
mind.  He  had  the  governess  touch  his  penis  with  her  shoes,  and  thus 
ejaculation  with  great  lustful  feeling  was  immediately  induced.  After 
separation  from  the  governess,  he  went  to  puellis,  whom  he  had  perform 
the  same  manipulation.  This  was  usually  sufficient  for  satisfaction. 
Only  seldom  did  he  resort  to  coitus  as  an  auxiliary,  and  inclination  for 
it  grew  less  and  less.  His  vita  sexualis  consisted  of  dream-pollutions, 
in  which  women's  shoes  played  the  exclusive  role ;  and  of  gratification 
with  women's  shoes  apposita  ad  mentulam,  but  this  had  to  be  done  by 
the  puella.  In  the  society  of  the  opposite  sex  the  only  thing  that  in- 
terested him  was  the  shoe,  and  that  only  when  it  was  elegant,  of  the 
French  style,  with  heels,  and  of  a  brilliant  black,  like  the  original. 

In  the  course  of  time  the  following  conditions  have  become  acces- 
sory :  A  prostitute's  shoe  that  is  elegant  and  chic ;  starched  petticoats, 
and  black  hose,  if  possible.  Nothing  else  in  woman  interests  him.  He 
is  absolutely  indifferent  to  the  naked  foot.  Women  have  not  the  slightest 
mental  charm  for  him.  He  had  never  had  masochistic  desires,  in  the 
sense  of  being  trod  upon.  In  the  course  of  years  his  fetichism  had 
gained  such  power  that  when  he  saw  a  lady  on  the  street,  of  a  certain 
appearance  and  with  certain  shoes,  he  was  so  intensely  excited  that 
lie  had  to  masturbate.  Slight  pressure  on  the  penis  sufficed  to  induce 
ejaculation,  in  his  state  of  severe  neurasthenia.  Shoes  displayed  in 
shops,  and,  of  late,  even  advertisements  of  shoes,  sufficed  to  excite  him 
intensely.  In  states  of  intense  libido  he  made  use  of  onanism,  if  shoes 
were  not  at  his  immediate  command.  The  patient  quite  early  recog- 
nized the  pain  and  danger  of  his  condition,  and,  even  when  he  was  free 
from  neurasthenic  ailments,  he  was  morally  very  much  depressed.     He 


FETICHISM.  177 

sought  help  of  various  physicians.  Cold-water  cures  and  hypnotism 
were  unsuccessful.  The  most  celebrated  physicians  advised  him  to 
marry,  and  assured  him  that,  as  soon  as  he  once  really  loved  a  girl,  lie 
would  be  free  from  his  fetichism.  The  patient  had  no  confidence  in  his 
future,  but  he  followed  the  advice  of  the  physicians.  He  was  cruelly 
disappointed  in  the  hope  which  the  authority  of  the  physicians  had 
aroused  in  him,  though  he  led  to  the  altar  a  lady  distinguished  by  both 
mental  and  physical  charms.  The  wedding-night  was  terrible ;  lie  felt 
like  a  criminal,  and  did  not  approach  his  wife.  The  next  day  he  saw  a 
prostitute  with  the  required  chic.  He  was  weak  enough  to  have  inter- 
course with  her  in  his  way.  Then  he  bought  a  pair  of  elegant  ladies' 
boots,  and  hid  them  in  bed,  and,  by  touching  them,  while  in  marital 
embrace,  after  a  few  daj^s,  he  was  able  to  perform  his  marital  duty.  He 
ejaculated  tardily,  for  he  had  to  force  himself  to  coitus ;  and,  after  a  few 
weeks,  this  artifice  failed,  because  his  imagination  failed.  He  felt 
unspeakably  miserable,  and  would  have  preferred  to  make  an  end  of 
himself.  He  could  no  longer  satisfy  his  wife,  who  was  sensual,  and 
much  excited  by  their  previous  intercourse ;  and  he  saw  her  suffering 
severely,  both  mentally  and  morally.  He  could  not,  and  would  not,  dis- 
close his  secret.  He  experienced  disgust  in  marital  intercourse ;  he  felt" 
afraid  of  his  wife,  and  feared  the  coming  of  night  and  being  alone  with 
her.     He  could  no  longer  induce  erection. 

He  again  made  attempts  with  prostitutes,  and  satisfied  himself  by 
touching  their  shoes.  Then  the  puella  had  to  touch  his  penis,  when  he 
would  have  ejaculation ;  but,  if  this  did  not  take  place,  he  would 
attempt  coitus  with  the  lewd  woman  ;  without  success,  however,  for 
ejaculation  would  occur  immediately.  In  absolute  despair,  the  patient 
comes  for  consultation.  He  deeply  regretted  that,  against  his  inner 
conviction,  he  had  followed  the  unfortunate  advice  of  the  physicians, 
and  made  a  virtuous  wife  unhappy,  having  deeply  injured  her,  both 
mentally  and  moralby.  Could  he  answer  God  for  continuing  such  a 
marriage?  Even  if  he  were  to  discover  himself  to  his  wife,  and  she 
were  to  do  everything  for  him,  it  would  not  help  him ;  for  the  familiar 
perfume  of  the  demi-monde  was  also  necessary. 

Aside  from  his  mental  pain,  this  unfortunate  man  presented  no 
remarkable  S3nnptoms.  Genitals  perfectly  normal.  Prostate  somewhat 
enlarged.  He  complained  that  he  was  so  under  the  domination  of  his 
boot-idens  that  he  would  even  blush  when  boots  were  talked  about.  His 
whole  imagination  was  given  up  to  such  ideas.  When  he  was  on  his 
estate,  he  often  suddenly  had  to  go  a  distance  of  ten  miles  to  the  city, 
to  satisfy  his  fetichism  with  shoe-stores  or  with  puellis. 

This  pitiable  man  could  not  bring  himself  to  take  treatment ;  for 
his  faith  in  plrysicians  had  been  greatly  shaken.  An  attempt  to  ascer- 
tain whether  hypnosis  and  a  removal  of  the  fetichistic  association  by 

this  means,  were  possible,  increased  the  mental  excitement  of  the  unfor- 

12 


178  PSYCHOPATHIA    SEXUALIS. 

tunate  man,  who  was  exclusively  controlled  by  the  thought  that  he  had 
made  his  wife  unhappy. 

Case  88.  X.,  aged  24,  from  a  badly -tainted  family  (mother's  brother 
and  grandfather  insane,  one  sister  epileptic,  another  sister  subject  to 
migraine,  parents  of  excitable  temperament).  During  dentition  he  had 
had  convulsions.  At  the  age  of  seven  he  was  taught  to  masturbate  by 
a  servant-girl.  X.  first  experienced  pleasure  in  these  manipulations 
when  this  girl  occasionally  stroked  his  penis  with  her  foot  with  her  shoe 
on.  Thus,  in  the  predisposed  boy,  an  association  was  established,  as  a 
result  of  which,  from  that  time  on,  merely  the  sight  of  women's  shoes, 
and,  finally,  merely  the  idea  of  them,  sufficed  to  induce  sexual  excite- 
ment and  erection.  He  now  masturbated  while  looking  at  women's 
shoes,  or  while  calling  them  up  in  imagination.  At  school  the  teacher's 
shoes  excited  him  intensely,  and  in  general  he  was  affected  by  shoes  that 
were  partly  concealed  b}'  female  garments.  One  day  he  could  not  keep 
from  grasping  the  teacher's  shoes, — an  act  that  caused  him  great  sexual 
excitement.  In  spite  of  punishment  he  could  not  keep  from  performing 
this  act  repeatedly.  Finally,  it  was  recognized  that  there  must  be  an 
abnormal  motive  in  phiy,  and  he  was  sent  to  a  male  teacher.  He  then 
reveled  in  the  memory  of  shoe-scenes  with  his  former  school-mistress, 
and  thus  had  erections,  orgasm,  and,  after  his  fourteenth  year,  ejacula- 
tion. At  the  same  time,  he  masturbated  while  thinking  of  a  woman's 
shoe.  One  day  the  thought  came  to  him  to  increase  his  pleasure  by 
using  such  a  shoe  for  masturbation.  Thereafter  he  frequently  took 
shoes  secretly,  and  used  them  for  that  purpose. 

Nothing  else  in  a  woman  could  excite  him  ;  the  thought  of  coitus 
filled  him  with  horror.  Men  did  not  interest  him  in  any  way.  At  the 
age  of  eighteen  he  opened  a  general  store,  and,  among  other  things 
handled  ladies'  shoes.  He  was  excited  sexually  by  fitting  shoes  for  his 
female  patrons,  or  by  manipulating  shoes  that  they  had  worn.  One  day, 
while  doing  this,  he  had  an  epileptic  attack,  and,  soon  after,  another, 
while  practicing  onanism  in  his  customary  way.  Then  he  recognized, 
for  the  first  time,  the  injury  to  health  caused  by  his  sexual  practices. 
He  tried  to  overcome  his  onanism,  sold  no  more  shoes,  and  strove  to 
free  himself  from  the  abnormal  association  between  women's  shoes  and 
the  sexual  function.  Then  frequent  pollutions,  with  erotic  dreams 
about  shoes,  occurred,  and  the  epileptic  attacks  continued.  Though 
devoid  of  the  slightest  feeling  for  the  female  sex,  he  determined  on 
marriage,  which  seemed  to  him  to  be  the  only  remed}\ 

He  married  a  pretty  young  lady.  In  spite  of  lively  erections 
when  he  thought  of  his  wife's  shoes,  in  attempts  at  cohabitation  he  was 
absolutely  impotent ;  for  his  distaste  for  coitus,  and  for  close  intercourse 
in  general,  was  far  more  powerful  than  the  influence  of  the  shoe-idea, 
which  induced  sexual  excitement.  On  account  of  his  impotence,  the 
patient  applied  to  Dr.  Hammond,  who  treated  his  epilepsy  with  bromides, 


FETICHISM.  179 

and  advised  him  to  hang  a  shoe  up  over  his  bed,  and  look  at  it  fixedly 
during  coitus,  at  the  same  time  imagining  his  wife  to  be  a  shoe.  The 
patient  became  free  from  epileptic  attacks,  and  potent  so  that  he  could 
havo  coitus  about  once  a  week.  Too,  his  sexual  excitation  by  women's 
shoes  grew  less  and  less.     (Hammond,  "  Sexual  Impotence.") 

Following  these  two  cases  of  shoe-f'etichism,  which  appar- 
ently depend  merely  upon  accidental  association,  and  are  not 
favored  by  any  inner  relation  between  the  things  themselves,  is 
given  the  very  strange  case  of  a  fetichist  who  was  excited  sexu- 
ally only  by  the  idea  of  a  night-cap  on  the  head  of  an  ugly 
old  woman ;  also  a  case  arising  apparently  from  merely 
accidental  association : — 

Case  89.  L.,  aged  3T,  clerk,  from  tainted  family,  had  his  first  erec- 
tion at  five  years,  when  he  saw  his  bed-fellow — an  aged  relative — put  on 
a  night-cap.  The  same  thing  occurred  later,  when  he  saw  an  old  servant 
put  on  her  night-cap.  Later,  simply  the  idea  of  an  old,  ugly  woman's 
head,  covered  with  a  night-cap,  was  sufficient  to  cause  an  erection. 
Simply  the  sight  of  a  cap,  or  of  a  naked  woman  or  man,  made  no  impres- 
sion, but  the  mere  touch  of  a  night-cap  induced  erection,  and  sometimes 
even  ejaculation.  L.  was  not  a  masturbator,  and  had  never  been  sexually 
active  until  his  thirty-second  year,  when  he  married  a  young  girl  with 
whom  he  had  fallen  in  love.  On  his  marriage-night  he  remained  cold 
until,  from  necessity,  he  brought  to  his  aid  the  memory -picture  of  an 
ugly  woman's  head  with  a  night-cap.  Coitus  was  immediately  suc- 
cessful. Thereafter  it  was  alwa3's  necessar}'  for  him  to  use  this  means. 
Since  childhood  he  had  been  subject  to  occasional  attacks  of  depression, 
with  tendency  to  suicide,  and  now  and  then  to  frightful  hallucinations 
at  night.  When  looking  out  of  windows,  he  became  dizzy  and  anxious. 
He  was  a  perverse,  peculiar,  and  easily  embarrassed  man,  of  bad  mental 
constitution.     (Charcot  and  Magnan,  Arch,  de  neurol.,  1882,  No.  12.) 

In  this  very  peculiar  case,  the  simultaneous  coincidence  of 
the  first  sexual  excitation  and  an  absolutely  heterogeneous 
impression  seems  to  have  determined  the  association. 

Hammond  (op.  clt.)  also  mentions  a  case  of  accidental 
associative  fetichism  that  is  quite  as  peculiar.  A  married  man, 
aged  30,  who,  in  other  respects,  was  healthy,  physically  and 
mentally,  is  said  to  have  suddenly  lost  his  sexual  power,  after 
moving  to  another  house,  and  to  have  regained  it  as  soon  as  the 
furniture  of  the  sleeping-room  had  been  arranged  as  it  was 
before.  . 


180  PSYCHOPATHIA   SEXUALIS. 

(c)  The  Fetich  is  Some  Special  Material. — There  is  a  third 
principal  group  of  fetichists  who  have  as  a  fetich  neither  a  por- 
tion of  the  female  body  nor  a  part  of  female  attire,  but  some 
particular  material  which  is  so  used,  not  because  it  is  a  material 
for  female  garments,  but  because  in  itself  it  can  arouse  or  in- 
crease sexual  feelings.  In  many  cases  of  this  kind,  the  act  of 
feeling  of  such  material  during  the  sexual  act  seems  indis- 
pensable, in  order  to  make  the  latter  possible,  or  at  least  satis- 
factory.    Such  materials  are  furs,  velvet,  and  silk. 

These  cases  differ  from  the  foregoing  instances  of  erotic 
dress- fetichism,  in  that  these  materials,  unlike  female  linen,  do 
not  have  any  close  relation  to  the  female  body ;  and,  unlike 
shoes  and  gloves,  they  are  not  related  to  certain  parts  of  the 
person  which  have  peculiar  symbolic  significance.  Moreover, 
this  fetichism  cannot  be  due  to  an  accidental  association,  like 
that  in  the  cases  of  the  night-caps  and  the  arrangement  of  the 
sleeping-room ;  for  these  cases  form  an  entire  group  having  the 
same  object.  It  must  be  presumed  that  certain  tactile  sensa- 
tions (a  kind  of  tickling  which  stands  in  some  distant  relation 
to  lustful  sensations'?),  in  hypersesthetic  individuals,  furnish  the 
occasion  for  the  origin  of  this  feticliism. 

The  following  is  a  personal  observation  of  a  man  affected 
with  this  peculiar  fetichism : — 

Case  90.  N.  N.,  aged  37  ;  of  a  neuropathic  family;  neuropathic 
constitiition.  ITe  makes  the  following  statement :  u  From  my  earliest 
youth  I  have  always  had  a  deeply-rooted  partiality  for  furs  and  velvet,  in 
that  these  materials  cause  me  sexual  excitement,  and  the  sight  and  touch 
of  them  give  me  lustful  pleasure.  I  can  recall  no  event  that  caused  this 
peculiarity  (such  as  the  simultaneous  occurrence  of  the  first  sexual  ex- 
citation and  an  impression  of  these  materials, — i.e.,  first  excitation  by  a 
woman  dressed  in  them)  ;  in  fact,  I  cannot  remember  when  this  enthusiasm 
began.  However,  by  this  I  would  not  exclude  the  possibility  of  such  an 
event, — of  an  accidental  connection  in  a  first  impression  and  consequent 
association ;  but  I  think  it  very  improbable  that  such  a  thing  took  place, 
because  I  believe  such  an  occurrence  would  have  deeply  impressed  me.  All 
I  know  is,  that  even  when  a  small  child  I  had  a  lively  desire  to  see  and 
stroke  furs,  and  thus  had  an  obscure  sensual  pleasure.  With  the  first 
occurrence  of  definite  sexual  ideas, — i.e.,  the  direction  of  sexual  thoughts  to 
woman, — the  peculiar  preference  for  women  dressed  in  such  materials  was 


FETICHISM.  181 

present.  Since  then,  up  to  mature  manhood,  it  has  remained  unchanged. 
A  woman  wearing  furs  or  velvet,  or,  better,  both,  excites  me  much  more 
quickly  and  intensely  than  one  devoid  of  these  auxiliaries.  To  be  sure, 
these  materials  are  not  a  conditio  sine  qua  non  of  excitation ;  the  desire 
occurs  also  without  them,  in  response  to  the  usual  stimuli ;  but  the  sight 
and,  particularly,  the  touch  of  these  fetich-materials  form  for  me  a 
powerful  aid  to  other  normal  stimuli,  and  intensify  erotic  pleasure.  Often 
merely  the  sight  of  only  a  passably  pretty  girl,  dressed  in  these  materials, 
causes  me  lively  excitement,  and  overcomes  me  completely.  Even  the 
sight  of  my  fetich-materials  gives  me  pleasure,  but  the  touch  of  them 
much  more.  (To  the  penetrating  odor  of  furs  I  am  indifferent — rather, 
it  is  unpleasant — and  it  is  endurable  only  by  reason  of  the  association 
with  pleasing  visual  and  tactile  impressions.)  I  have  an  intense  longing 
to  touch  these  materials  while  on  a  woman's  person,  to  stroke  and  kiss 
them,  and  bury  my  face  in  them.  My  greatest  pleasure  is,  inter  actum, 
to  see  and  feel  my  fetich  on  the  woman's  shoulder. 

"  Fur,  or  velvet  alone,  exerts  on  me  the  effect  described,  the  former 
much  more  intensely  than  the  latter.  The  combination  of  the  two  has 
the  most  intense  effect.  Too,  female  garments  of  velvet  and  fur,  seen  and 
touched  without  the  wearer,  cause  me  sexual  excitement ;  indeed,  though 
to  a  less  extent,  the  same  effect  is  exerted  by  furs  or  robes  having  no 
relation  to  female  attire,  and  also  by  the  velvet  and  plush  of  furniture 
and  drapery.  Merely  pictures  of  costumes  of  furs  and  velvet  are  objects 
of  erotic  interest  to  me ;  indeed,  simply  the  word  "  fur  "  has  a  magic  charm 
for  me,  and  immediately  calls  up  erotic  ideas. 

"  Fur  is  such  an  object  of  sexual  interest  for  me  that  a  man  wearing 
fur  that  is  effective  (v.  infra)  makes  a  very  unpleasant,  repugnant,  and 
disgusting  impression  on  me ;  such  as  would  be  made  on  a  normal  person 
by  a  man  in  the  costume  and  attire  of  a  ballet-dancer.  Similarly  repug- 
nant to  me  is  the  sight  of  an  old  or  ugly  woman  clad  in  beautiful  furs ; 
because  opposing  feelings  are  thus  aroused. 

"  This  erotic  delight  in  furs  and  velvet  is  something  entirely  differ- 
ent from  simple  aesthetic  pleasure.  I  have  a  very  lively  appreciation  of 
beautiful  female  attire,  and,  at  the  same  time,  a  particular  partiality  for 
point-lace ;  but  it  is  purely  of  an  aesthetic  nature.  A  woman  dressed  in 
a  point-lace  toilette  (or  in  other  elegant,  elaborate  attire)  is  more  beautiful 
than  another ;  but  one  dressed  in  my  fetich-material  is  more  charming. 

"  But  furs  exercise  on  me  the  effect  described  only  when  the  fur  has 
very  thick,  fine,  smooth,  and  rather  long  hair,  that  stands  out  like  that  of 
the  so-called  bearded  furs.  I  have  noticed  that  the  effect  depends  upon 
this.  I  am  entirely  indifferent  not  only  to  the  common  coarse,  bushy 
furs,  but  also  to  those  that  are  commonly  regarded  as  beautiful  and 
precious,  from  which  the  long  hair  has  been  removed  (seal,  beaver),  or 
of  which  the  hair  is  naturally  short  (ermine) ;  and  likewise  to  those  of 
which  the  hair  is  over-long  and  lies  down  (monkey,  bear).     The  specific 


182  PSYCHOPATHIA   SEXUALlS. 

effect  is  exerted  only  by  the  standing  long  hair  of  the  sable,  marten, 
skunk,  etc.  But  velvet  is  made  of  thick,  fine,  standing  hairs  (fibres) ; 
and  its  effect  may  be  due  to  this.  The  effect  seems  to  depend  upon  a 
very  definite  impression  of  the  points  of  thick,  fine  hair  upon  the  end- 
Cttgans  of  the  sensory  nerves. 

"  But  how  this  peculiar  impression  on  the  tactile  nerves  is  related  to 
sexual  instinct  is  a  perfect  enigma  to  me.  The  fact  is,  that  this  is  the 
case  with  many  men.  I  would  also  state  expressly  that  beautiful  female 
hair  pleases  me,  but  plays  no  more  important  part  than  the  other  charm ; 
and  that  while  touching  fur  I  have  no  thought  of  female  hair.  The  tac- 
tile sensation,  also,  has  not  the  least  resemblance  to  that  imparted  by 
female  hair.  There  is  never  association  of  any  other  idea.  Fur,  per  se, 
arouses  sensuality  in  me, — how,  I  cannot  explain. 

"  The  mere  aesthetic  effect,  the  beauty  of  costly  furs,  to  which  every 
one  is  more  or  less  susceptible ;  which,  since  Raphael's  Fornarina  and 
Reuben's  Helene  Fourment,  has  been  used  as  the  foil  and  frame  of 
female  beauty  by  innumerable  painters ;  and  which  plays  so  important  a 
role  in  fashion, — the  art  and  science  of  female  dress, — this  aesthetic  effect, 
as  has  been  remarked,  explains  nothing  here.  Beautiful  furs  have  the 
same  aesthetic  effect  on  me  as  on  normal  individuals,  and  affect  me  in  the 
same  way  that  flowers,  ribbons,  precious  stones,  and  other  ornaments 
affect  every  one.  Such  things,  when  skillfully  used,  enhance  female 
beauty,  and  thus,  under  certain  circumstances,  may  have  an  indirect  sen- 
sual effect.  They  never  have  a  direct,  powerful,  sensual  effect  on  me,  as 
do  the  fetich-materials  mentioned. 

"  Though  in  me,  and,  in  fact,  in  all  '  fetichists,'  the  sensual  and  aes- 
thetic effect  must  be  strictly  differentiated,  nevertheless,  that  does  not 
prevent  me  from  demanding  in  my  fetich  a  whole  series  of  aesthetic  qual- 
ities in  form,  style,  color,  etc.  I  could  give  a  very  lengthy  description 
of  these  qualities  that  my  taste  demands ;  but  I  omit  it  as  not  being 
essential  to  the  real  subject  in  hand.  I  would  only  call  attention  to  the 
fact  that  erotic  fetichism  is  complicated  with  purely  aesthetic  tastes. 

"  The  specific  erotic  effect  of  my  fetich-materials  can  be  explained  no 
better  by  the  association  with  the  idea  of  the  person  of  the  female  wear- 
ing them,  than  by  their  aesthetic  impression.  For,  in  the  first  place,  as 
has  been  said,  these  materials,  as  such,  affect  me  when  entirely  isolated 
from  the  body ;  and,  in  the  second  place,  articles  of  clothing  of  a  much 
more  private  nature,  and  which  undoubtedly  call  up  associations,  exert  a 
much  weaker  influence  over  me.  Thus  the  fetich-materials  have  an  inde- 
pendent sensual  value  for  me ;  why,  is  an  enigma  to  me. 

"  Feathers  in  women's  hats,  fans,  etc.,  have  the  same  erotic  fetichistic 
effect  on  me  as  furs  and  velvet  (similar  tactile  sensation  of  airy,  peculiar 
tickling).  Finally,  the  fetichistic  effect,  with  much  less  intensity,  is 
exerted  by  other  smooth  materials  (satin  and  silk) ;  but  rough  goods 
(cloth,  flannel)  have  a  repelling  effect. 


FETICHISM.  183 

u  In  conclusion,  I  will  mention  that  somewhere  I  read  an  article  by 
Carl  Vogt  on  microcephalic  men,  according  to  which  these  creatures,  at 
the  sight  of  furs,  rushed  for  them  and  stroked  them  with  every  manifes- 
tation of  delight.  I  am  far  from  any  thought,  on  this  ground,  to  see  in 
wide-spread  fur-fetichism  an  atavistic  retrogression  to  the  taste  of  our 
hairy  ancestors.  Every  cretin,  with  that  simplicity  belonging  to  his  con- 
dition, touches  anything  that  pleases  him  ;  and  the  act  is  not  necessarily 
of  a  sexual  nature;  just  as  many  normal  men  like  to  stroke  a  cat  and 
the  like,  or  even  velvet  and  furs,  and  are  not  thus  excited  sexually." 

Iii  the  literature  of  this  subject,  there  are  a  few  cases 
belonging  here : — 

Case  91.  A  boy,  aged  12,  became  powerfully  excited  sexually  when 
he  chanced  to  put  on  a  fox-skin.  From  that  time  there  was  masturbation 
with  the  employment  of  furs,  or  by  means  of  taking  a  furry  dog  to  bed. 
Ejaculation  would  result,  sometimes  followed  by  an  hysterical  attack. 
His  nocturnal  pollutions  were  induced  by  dreaming  that  he  lay  entirely 
covered  up  in  a  white  skin.  He  was  absolutely  insusceptible  to  stimuli 
coming  from  men  or  women.  He  was  neurasthenic,  suffered  with  delu- 
sions of  being  watched,  and  thought  that  every  one  noticed  his  sexual 
anomaly.  He  had  taedium  vitse  on  account  of  this,  and  finally  became 
insane.  He  had  marked  taint ;  his  genitals  were  imperfectly  formed,  and 
he  presented  other  signs  of  degeneration.     (Tarnowsky,  op.  cit.,  p.  22.) 

Case  92.  C.  is  an  especial  lover  of  velvet.  He  is  attracted  in  a 
normal  way  by  beautiful  women,  but  it  particularly  excites  him  to  have 
the  person  with  whom  he  has  sexual  intercourse  dressed  in  velvet.  In 
this,  it  is  remarkable  that  it  is  not  so  much  the  sight  as  the  touch  of  the 
velvet  that  causes  the  excitation.  C.  told  me  that  stroking  a  woman's 
velvet  jacket  would  excite  him  sexually  to  an  extent  scarcely  possible  in 
any  other  way.     (Dr.  Moll,  op.  cit.,  p.  127.) 

The  following  is  a  very  peculiar  case  of  material-fetichism. 
It  is  combined  with  the  impulse  to  injure  the  fetich,  which,  in 
this  case,  represents  an  element  of  sadism  toward  the  woman 
wealing  the  fetich,  or  impersonal  sadism  toward  objects,  which 
is  of  frequent  occurrence  in  fetichists  (comp.  p.  170).  This 
impulse  to  injure  made  this  a  remarkable  criminal  case : — 

Case  93.  In  July,  1891,  Alfred  Bachmann,  aged  25,  locksmith,  was 
brought  before  Judge  I.,  in  the  second  term  of  the  criminal  court,  in 
Berlin.  In  April,  1891,  the  police  had  had  numerous  complaints,  accord- 
ing to  which  some  evil  hand  had  cut  women's  dresses  with  a  very  sharp 
instrument.     On  April  253  they  were  successful  in  arresting  the  perpe- 


184  PSYCHOPATH!  A   SEXUALIS. 

trator  in  the  person  of  the  accused.  A  policeman  noticed  how  the  ac- 
cused pressed,  in  a  remarkable  manner,  against  a  lady  in  the  company  of 
a  gentleman,  while  they  were  going  through  a  passage.  The  officer 
requested  the  lady  to  examine  her  dress,  while  he  held  the  man  under 
suspicion.  It  was  ascertained  that  the  dress  had  received  quite  a  long 
slit.  The  accused  was  taken  to  the  station,  where  he  was  examined. 
Besides  a  sharp  knife,  which  he  confessed  he  used  for  cutting  dresses, 
two  silk  sashes,  such  as  ladies  wear  on  their  dresses,  were  found  on  him  ; 
he  also  confessed  that  he  had  taken  these  from  dresses  in  crowds.  Finally, 
the  examination  of  his  person  brought  to  light  a  lady's  silk  neck-cloth. 
The  accused  said  he  had  found  this.  Since  his  statement  in  this  case 
could  not  be  refuted,  complaint  was  therefore  made  to  rest  on  the  result 
of  the  search ;  in  two  instances  in  which  complaint  was  made  by  the 
injured  parties  his  acts  were  designated  as  injury  to  property,  and  in  two 
other  instances  as  theft.  The  accused,  a  man  who  had  been  often  pun- 
ished before,  with  a  pale,  expressionless  face,  before  the  judge,  gave  a 
strange  explanation  of  his  enigmatical  action.  A  major's  cook  had  once 
thrown  him  down-stairs  when  he  was  begging  of  her,  and  since  that  time 
he  had  entertained  great  hatred  of  the  whole  female  sex.  There  was  a 
doubt  about  his  responsibilit}-,  and  he  was  therefore  examined  by  a  phy- 
sician. The  medical  expert  gave  the  opinion,  at  the  final  trial,  that  there 
was  no  reason  to  regard  the  accused  as  insane,  though  he  was  of  low 
intelligence.  The  culprit  defended  himself  in  a  peculiar  manner.  An 
irresistible  impulse  forced  him  to  approach  women  wearing  silk  dresses. 
The  touch  of  silk  material  gave  him  a  feeling  of  delight,  and  this  went 
so  far  that,  while  in  prison  for  examination,  he  had  been  excited  if  a  silk 
thread  happened  to  pass  through  his  fingers  while  raveling  rags.  Judge 
Muller  considered  the  accused  to  be  simply  a  dangerous,  vicious  man, 
who  should  be  made  harmless  for  a  long  time.  He  advised  imprison- 
ment for  one  year.  The  court  sentenced  him  to  six  months'  imprisonment, 
with  loss  of  honor  for  a  year. 

The  following  case  was  communicated  to  me  by  a  phy- 
sician : — 

In  a  brothel  a  certain  man  was  known  by  the  name  of  "  Velvet." 
He  dressed  a  puella  pleasing  to  him  in  a  black  velvet  dress,  and  excited 
and  satisfied  his  sexual  appetite  simply  by  stroking  his  face  with  a  part 
of  the  velvet  skirt,  touching  the  woman  in  no  other  way. 

I  am  assured  by  an  officer  that,  among  masochists,  a 
partiality  for  furs,  velvet,  and  feathers,  is  very  frequent  (comp. 
Case  44).  In  the  novels  of  Sacher-Masoch,  fur  plays  an  im- 
portant part ;  indeed,  it  furnishes  a  title  to  some  of  them.  The 
explanation  given  there  seems  far-fetched  and  unsatisfactory, — 


HOMO-SEXUALITY.  185 

that  fur  (ermine)  is  the  symbol  of  royalty,  and  therefore  the 
fetich  of  the  men  described  in  the  novels. 

II.  Great  Diminution  or  Complete  Absence  of  Sexual  Feeling  for  the 
Opposite  Sex,  with  Substitution  of  Sexual  Feeling  and  Instinct  for  the 
Same  Sex:     (Homosexuality ,  or  Contrary  Sexual  Instinct). 

After  the  attainment  of  complete  sexual  development, 
among  the  most  constant  elements  of  self-consciousness  in  the 
individual,  are  the  knowledge  of  representing  a  definite  sexual 
personality  and  the  consciousness  of  desire,  during  the  period 
of  physiological  activity  of  the  reproductive  organs  (production 
of  semen  and  ova),  to  perform  sexual  acts  corresponding  with 
that  sexual  personality, — acts  which,  consciously  or  uncon- 
sciously, have  a  procreative  purpose. 

The  sexual  instinct  and  desire,  save  for  indistinct  feelings 
and  impulses,  remain  latent  until  the  period  of  development  of 
the  sexual  organs.  The  child  is  generis  rieutrius  ;  and  though, 
during  this  latent  period, — when  sexuality  has  not  yet  risen  into 
clear  consciousness,  is  but  virtually  present,  and  unconnected 
with  powerful  organic  sensations, — too  early  excitation  of  the 
genitals  may  occur,  either  spontaneously  or  as  a  result  of  ex- 
ternal influence,  and  find  satisfaction  in  masturbation;  yet, 
notwithstanding  this,  the  psychical  relation  to  persons  of  the 
opposite  sex  is  still  absolutely  wanting,  and  the  sexual  acts 
during  this  period  partake  more  or  less  of  a  reflex  spinal  nature. 

The  fact  of  innocence,  or  of  sexual  neutrality,  is  the  more 
remarkable,  since  very  early,  in  education,  employment,  dress, 
etc.,  the  child  undergoes  a  differentiation  from  children  of  the 
opposite  sex.  These  impressions,  however,  remain  destitute  of 
mental  meaning,  because  they  apparently  are  without  sexual 
coloring;  for  the  central  organ  (cortex)  of  sexual  emotions  and 
ideas  is  not  yet  capable  of  activity,  owing  to  its  undeveloped 
condition. 

With  the  inception  of  anatomical  and  functional  develop- 
ment of  the  generative  organs,  and  the  differentiation  of  form 
belonging  to  each  sex,  which  goes  hand  in  hand  with  it  in  the 
boy  or  girl,  rudiments  of  a  mental  feeling  corresponding  with 


186  PSYCEIOPATHIA    SEXUALIS. 

the  sex  are  developed ;  and  in  this,  of  course,  education  and 
external  influences  in  general  have  a  powerful  effect  upon  the 
individual,  who  is  now  all  attention. 

If  the  sexual  development  is  normal  and  undisturbed,  a 
definite  character,  corresponding  with  the  sex,  is  developed. 
Certain  definite  inclinations  and  reactions  in  intercourse  with 
persons  of  the  opposite  sex  arise ;  and  it  is  psychologically 
worthy  of  note  with  what  relative  rapidity  the  definite  mental 
type  corresponding  with  the  sex  is  evolved. 

While  modesty,  for  example,  during  childhood,  is  essen- 
tially but  an  uncomprehended  and  incomprehensible  exaction  of 
education  and  imitation,  and  in  the  innocence  and  naivete  of 
the  child  but  imperfectly  expressed  ;  in  the  youth  and  maiden  it 
becomes  an  imperative  requirement  of  self-respect;  and,  if  in  any 
way  it  is  offended,  intense  vasomotor  reaction  (blushing)  and 
psychical  emotion  are  induced. 

If  the  original  constitution  is  favorable  and  normal,  and 
factors  injurious  to  the  psycho-sexual  development  exercise  no 
influence,  then  a  psycho-sexual  personality  is  developed  that  is  so 
unchangeable,  and  corresponds  so  completely  and  harmoniously 
with  the  sex  the  individual  represents,  that  subsequent  loss  of 
the  generative  organs  (as  by  castration),  or  the  climacteric  or 
senility,  cannot  essentially  alter  it.  But  this,  of  course,  is  not 
to  declare  that  the  castrated  man  or  woman,  the  youth  and 
the  aged  man,  the  maiden  and  matron,  the  impotent  and  the 
potent  man,  do  not  differ  essentially  from  one  another  mentally. 

An  interesting  and  important  question  for  what  follows 
is,  whether  the  peripheral  influences  of  the  generative  glands 
(testes  and  ovaries),  or  central  cerebral  conditions,  are  the 
determining  factors  in  psycho-sexual  development.  The  fact 
that  congenital  deficiency  of  the  generative  glands,  or  removal 
of  them  before  puberty,  has  a  great  influence  on  physical  and 
psycho-sexual  development,  so  that  the  latter  is  distorted  and 
assumes  a  type  more  closely  resembling  the  opposite  sex 
(eunuchs,  certain  viragoes,  etc.),  betokens  their  great  importance 
in  this  respect. 

But  that  the  physical  processes  taking  place  in  the  genital 


HOMOSEXUALITY.  187 

organs  are  only  co-operative,  and  not  the  exclusive  factors  in 
the  process  of  development  of  the  psycho-sexual  character,  is 
shown  by  the  fact  that,  notwithstanding  a  normal  anatomical 
and  physiological  state  of  these  organs,  a  sexual  instinct  may 
be  developed  which  is  the  exact  opposite  of  that  characteristic 
of  the  sex  to  which  the  individual  belongs. 

In  this  case,  the  cause  is  to  be  sought  only  in  an  anomaly 
of  central  conditions, — in  an  abnormal  psycho-sexual  consti- 
tution. This  constitution,  as  far  as  its  anatomical  and  functional 
foundation  is  concerned,  is  absolutely  unknown.  Since,  in 
almost  all  such  cases,  the  individual  subject  to  the  perverse 
sexual  instinct  displays  a  neuropathic  predisposition  in  several 
directions,  and  the  latter  may  be  brought  into  relation  with 
hereditary  degenerate  conditions,  this  anomaly  of  psycho-sexual 
feeling  may  be  called,  clinically,  a  functional  sign  of  degeneration. 
This  perverse  sexuality  appears  spontaneously,  without  external 
cause,  with  the  development  of  sexual  life,  as  an  individual 
manifestation  of  an  abnormal  form  of  the  vita  sexualis,  and 
then  has  the  force  of  a  congenital  phenomenon ;  or  it  develops 
upon  a  sexuality  the  beginning  of  which  was  normal,  as  a  result 
of  very  definite  injurious  influences,  and  thus  appears  as  an 
acquired  anomaly.  Upon  what  this  enigmatical  phenomenon 
of  acquired  homo-sexual  instinct  depends  is  still  inexplicable, 
and  only  a  matter  for  hypothesis.  Careful  examination  of  the 
so-called  acquired  cases  makes  it  probable  that  the  predisposition 
also  present  here  consists  of  a  latent  homo-sexuality,  or,  at  least, 
bi-sexuality,  which,  for  its  manifestation,  requires  the  influence 
of  accidental  exciting  causes  to  rouse  it  from  its  slumber. 

In  so-called  contrary  sexual  instinct  there  are  degrees  of 
the  phenomenon  whicli  quite  correspond  with  the  degrees  of 
predisposition  of  the  individuals.  Thus,  in  the  milder  cases, 
there  is  simple  hermaphroditism  ;  in  more  pronounced  cases,  only 
homo-sexual  feeling  and  instinct,  but  limited  to  the  vita  sexualis; 
in  still  more  complete  cases,  the  whole  psychical  personality,  and 
even  the  bodily  sensations,  are  transformed  to  correspond  with 
the  sexual  perversion  ;  and,  in  the  complete  cases,  the  physical 
form  is  correspondingly  altered. 


188  PSYCHOPATHIA   SEXtTALlS. 

The  following  division  of  the  various  phenomena  of  this 
psycho-sexual  anomaly  is  made,  therefore,  in  accordance  with 
these  clinical  facts : — 

A.  Homo-sexual  Feeling  as  an  Acquired  Manifestation. — 
The  determining  condition  here  is  the  demonstration  of  per- 
verse feeling  for  the  same  sex ;  not  the  proof  of  sexual  acts  with 
the  same  sex.  These  two  phenomena  must  not  be  confounded 
with  each  other ;  perversity  must  not  be  taken  for  perversion. 

Perverse  sexual  acts,  not  dependent  upon  perversion,  often 
come  under  observation.  This  is  especially  true  with  reference 
to  sexual  acts  between  persons  of  the  same  sex,  particularly 
pederasty.  Here  paresthesia  sexualis  is  not  necessarily  at 
work ;  but  hyperesthesia,  with  physical  or  mental  impossi- 
bility of  natural  sexual  satisfaction.  Thus  we  find  homo- 
sexual intercourse  in  impotent  masturbators  or  debauchees,  or 
faute  de  mieux  in  sensual  men  and  women  in  imprisonment,  on 
ship-board,  in  garrisons,  bagnios,  boarding-schools,  etc. 

There  is  an  immediate  return  to  normal  sexual  intercourse 
as  soon  as  obstacles  to  it  are  removed.  Very  frequently  the 
cause  of  such  temporary  aberration  is  masturbation  and  its 
results  in  youthful  individuals. 

Nothing  is  so  prone  to  contaminate — under  certain  circum- 
stances, even  to  exhaust — the  source  of  all  noble  and  ideal 
sentiments,  which  arise  of  themselves  from  a  normally  develop- 
ing sexual  instinct,  as  the  practice  of  masturbation  in  early 
years.  It  despoils  the  unfolding  bud  of  perfume  and  beauty, 
and  leaves  behind  only  the  coarse,  animal  desire  for  sexual  sat- 
isfaction. If  an  individual,  spoiled  in  this  manner,  reaches  an 
age  of  maturity,  there  is  wanting  in  him  that  aesthetic,  ideal, 
pure,  and  free  impulse  which  draws  one  toward  the  opposite 
sex.  Thus  the  glow  of  sensual  sensibility  wanes,  and  the 
inclination  toward  the  opposite  sex  becomes  weakened.  This 
defect  influences  the  morals,  character,  fancy,  feeling,  and 
instinct  of  the  youthful  masturbator,  male  or  female,  in  an 
unfavorable  way,  and,  under  certain  circumstances,  allows  the 
desire  for  the  opposite  sex  to  sink  to  nil ;  so  that  masturbation  is 
preferred  to  the  natural  mode  of  satisfaction. 


ACQUIRED    HOMO-SEXUALITY.  189 

Sometimes  the  development  of  higher  sexual  feelings 
toward  the  opposite  sex  suffers,  on  account  of  hypochondriacal 
fear  of  infection  in  sexual  intercourse;  or  on  account  of  an 
actual  infection ;  or  they  suffer  as  a  result  of  a  faulty  education 
which  points  out  such  dangers  and  exaggerates  them.  Again 
(especially  in  females),  fear  of  the  result  of  coitus  (pregnancy), 
or  abhorrence  of  men,  by  reason  of  mental  or  moral  weakness, 
may  direct  into  perverse  channels  an  instinct  that  makes  itself 
felt  with  abnormal  intensity.  But  too  early  and  perverse  sexual 
satisfaction  injures  not  merely  the  mind,  but  also  the  body;  inas- 
much as  it  induces  neuroses  of  the  sexual  apparatus  (irritable 
weakness  of  the  centres  governing  erection  and  ejaculation ; 
defective  pleasurable  feeling  in  coitus),  while,  at  the  same 
time,  it  maintains  the  imagination  and  libido  in  continuous 
excitement. 

Almost  every  masturbator  at  last  reaches  a  point  where, 
frightened  on  learning  the  results  of  the  vice,  or  on  experiencing 
them  (neurasthenia),  or  led  by  example  or  seduction  to  the  op- 
posite sex,  he  wishes  to  free  himself  of  the  vice  and  re-instate  his 
vita  sexualis.  The  moral  and  mental  conditions  are  the  most  un- 
favorable possible.  The  pure  glow  of  sexual  feeling  is  destroyed  ; 
the  fire  of  sexual  instinct  is  wanting,  and  self-confidence,  no 
less ;  for  every  masturbator  is  more  or  less  timid  and  cowardly. 
If  the  youthful  sinner  at  last  comes  to  make  an  attempt  at 
coitus,  he  is  either  disappointed  because  enjoyment  is  wanting, 
on  account  of  defective  sensual  feeling,  or  he  is  lacking  in  the 
mental  strength  necessary  to  accomplish  the  act.  The  fiasco 
has  a  fatal  effect,  and  leads  to  absolute  psychical  impotence.  A 
bad  conscience  and  the  memory  of  past  failures  prevent  success 
in  any  further  attempts.  The  constant  libido  sexualis,  however, 
demands  satisfaction ;  but  this  moral  and  mental  perversion 
separates  him  further  and  further  from  women.  For  various 
reasons,  however  (neurasthenic  complaints,  hypochondriacal 
fear  of  the  results,  etc.),  the  individual  is  kept  from  masturba- 
tion. Occasionally,  under  such  circumstances,  there  may  be 
bestiality.  Intercourse  with  the  same  sex  is  then  near  at 
hand, — as  a  result  of  occasional  seduction  or  of  the  feelings  of 


190  PSTCHOPATHIA   SEXUALIS. 

friendship  which,  on  the  level  of  pathological  sexuality,  easily 
associate  themselves  with  sexual  feelings.  Passive  and  mutual 
onanism  then  becomes  the  equivalent  of  the  avoided  act.  If 
there  is  a  seducer, — which,  unfortunately,  is  so  frequent, — then 
the  cultivated  pederast  is  produced, — i.e.,  a  man  who  performs 
quasi  acts  of  onanism  with  persons  of  his  own  sex,  and,  at  the 
same  time,  feels  and  prefers  himself  in  an  active  role  correspond- 
ing with  his  real  sex ;  who  is  mentally  indifferent  not  only  to 
persons  of  the  opposite  sex,  but  also  to  those  of  his  own  sex. 

Sexual  aberration  in  the  normally  constituted,  untainted, 
mentally  healthy  individual,  reaches  this  degree.  No  case  has 
been  demonstrated  in  which  perversity  has  been  transformed 
into  perversion, — into  a  reversal  of  the  sexual  instinct.1 

With  tainted  individuals,  the  matter  is  quite  different.  The 
latent  perverse  sexuality  is  developed  under  the  influence  of 
neurasthenia  induced  by  masturbation,  abstinence,  or  otherwise. 

Gradually,  in  contact  with  persons  of  the  same  sex,  sexual 
excitation  by  them  is  induced.     Related  ideas  are  colored  with 


1  Gamier  (Anomalies  Sexuelles,  Paris,  pp.  508,  509)  reports  two  cases  (Cases  222 
aud  223)  that  are  apparently  opposed  to  this  assumption,  particularly  the  first,  in  which 
despair  about  the  unfaithfulness  of  a  lover  led  the  individual  to  submit  to  the  seductions 
of  men.  But  the  case  itself  clearly  shows  that  this  individual  never  found  pleasure  in 
homo-sexual  acts.  In  Case  223,  the  individual  was  effeminated  db  origine,  or  was  at  least  a 
psychical  hermaphrodite. 

Those  who  hold  to  the  opinion  that  the  origin  of  homo-sexual  feelings  and  instinct 
is  found  to  be  exclusively  in  defective  education  and  other  psychological  influences  are 
entirely  in  error. 

An  untainted  male  may  be  raised  never  so  much  like  a  female,  and  a  female  like  a 
male,  but  they  will  not  become  homo-sexual.  The  natural  disposition  is  the  determining 
condition ;  not  education  and  other  accidental  circumstances,  like  seduction.  There  can  be 
no  thought  of  contrary  sexual  instinct  save  when  the  person  of  the  same  sex  exerts  a 
psycho-sexual  influence  on  the  individual,  and  thus  brings  about  libido  and  orgasm, — i.e., 
has  a  psychical  attraction.  Those  cases  are  quite  different  in  which,  faute  de  ndeux,  with 
great  sensuality  and  a  defective  aesthetic  sense,  the  body  of  a  person  of  the  same  sex  is  used 
for  an  onanistic  act  (not  for  coitus  in  a  psychical  sense). 

In  his  excellent  monograph,  Moll  shows  very  clearly  and  convincingly  the  impor- 
tance of  original  predisposition  in  contrast  with  exciting  causes  (comp.  op.  cit.,  pp.  156- 
175).  He  knows  "  many  cases  where  early  sexual  intercourse  with  men  was  not  capable 
of  inducing  perversion."  Moll  significantly  says,  further  :  "  I  know  of  such  an  epidemic 
(of  mutual  onanism)  in  a  Berlin  school,  where  a  person  who  is  now  an  actor  shamelessly 
introduced  mutual  onanism.  Though  I  now  know  the  names  of  very  many  urnings  in 
Berlin,  yet  I  could  not  ascertain,  even  with  anything  like  probability,  that  among  all  th» 
scholars  of  that  school  at  that  time  there  was  one  that  had  become  an  uruing  ;  but,  on  the 
other  hand,  I  have  quite  certain  knowledge  that  many  of  those  scholars  are  now  normal 
sexually,  in  feeling  and  intercourse." 


ACQUIRED    HOMO-SEXUALITY.  191 

lustful  feelings,  and  awaken  corresponding  desires.  This 
decidedly  degenerate  reaction  is  the  beginning  of  a  process  of 
physical  and  mental  transformation,  a  description  of  which  is 
attempted  in  what  follows,  and  which  is  one  of  the  most  inter- 
esting psychological  phenomena  that  has  been  observed.  This 
metamorphosis  presents  different  stages,  or  degrees. 

I.  Degree :  Simple  Reversal  of  Sexual  Feeling. — This 
degree  is  attained  when  persons  of  the  same  sex  have  an 
aphrodisiac  effect,  and  the  individual  has  a  sexual  feeling  for 
them.  Character  and  feeling,  however,  still  correspond  with 
the  sex  of  the  individual  presenting  the  reversal  of  sexual  feel- 
ing. He  feels  himself  in  the  active  role ;  he  recognizes  his 
impulse  toward  his  own  sex  as  an  aberration,  and  finally  seeks 
aid.  With  episodical  improvement  of  the  neurosis,  at  first  even 
normal  sexual  feelings  may  re-appear  and  assert  themselves. 
The  following  case  seems  well  suited  to  exemplify  this  stage  of 
the  psycho-sexual  degeneration : — 

Case  94.  Acquired  Contrary  Sexual  Instinct. — "  I  am  an  official,  and, 
as  far  as  I  know,  come  of  an  untainted  family.  My  father  died  of  an  acute 
disease ;  my  mother  is  living  and  is  quite  nervous.  A  sister  has  been  very 
intensely  religious  for  some  years. 

"  I  myself  am  tall,  and,  in  speech,  gait,  and  manner,  give  a  perfectly 
masculine  impression.  Measles  is  the  only  disease  I  have  had ;  but  since 
my  thirteenth  }-ear  I  have  suffered  with  so-called  nervous  headache. 
My  sexual  life  began  in  my  thirteenth  year,  when  I  became  acquainted 
with  a  boy  somewhat  older  than  myself,  with  whom  I  took  pleasure  in 
mutual  fondling  of  the  genitals.  I  had  the  first  ejaculation  in  my  four- 
teenth year.  Seduced  to  onanism  by  two  older  school-mates,  I  practiced 
it  partly  with  others  and  partly  alone ;  in  the  latter  case,  however,  always 
with  the  thought  of  persons  of  the  female  sex.  My  libido  sexualis  was 
very  great,  as  it  is  to-day.  Later,  I  tried  to  win  a  pretty,  stout  servant- 
girl  who  had  very  large  mammae  ;  id  solum  assecutus  sum,  ut  me  praesente 
superiorem  corporis  sui  partem  enudaret  mihique  concederet  os  mam- 
masque  osculari,  dum  ipsa  penem  meum  valde  erectum  in  manum  suam 
recepit  eumque  trivit. 

"  Notwithstanding  my  urgent  demand  for  coitus,  she  would  not 
allow  it ;  but  she  finally  permitted  me  to  touch  her  genitals. 

"  After  going  to  the  University,  I  visited  a  brothel  and  succeeded 
without  especial  effort. 

"  There  an  event  occurred  which  brought  a  change  in  me.     One 


192  PSYCHOPATHIA   SEXUALIS. 

evening  I  accompanied  a  friend  home,  and  in  a  mild  state  of  intoxication 
I  grasped  him  ad  genitalia.  He  made  but  slight  opposition.  I  then  went 
up  to  his  room  with  him,  and  we  practiced  mutual  masturbation.  From 
that  time  we  indulged  in  it  quite  frequently ;  in  fact,  it  came  to  immissio 
penis  in  os,  with  resultant  ejaculations.  But  it  is  strange  that  I  was  not 
at  all  in  love  with  this  person,  but  passionately  in  love  with  another 
friend,  near  whom  I  never  felt  the  slightest  sexual  excitement,  and  whom 
I  never  connected  with  sexual  matters,  even  in  thought.  My  visits  to 
brothels,  where  I  was  gladly  received,  became  more  infrequent;  in  my 
friend  I  found  a  substitute,  and  did  not  desire  sexual  intercourse  with 
women. 

"  We  never  practiced  pederast}',  and  that  word  was  not  even  known 
between  us.  From  the  beginning  of  this  relation  with  my  friend,  I  again 
masturbated  more  frequent^,  and  naturally  the  thought  of  females  re- 
ceded more  and  more  into  the  background,  and  I  thought  more  and 
more  about  young,  handsome,  strong  men  with  the  largest  genitals. 
I  preferred  young  fellows,  from  sixteen  to  twenty -five  years  old,  without 
beards,  but  they  had  to  be  handsome  and  clean.  Young  laborers  dressed 
in  trousers  of  Manchester  cloth  or  English  leather,  particularly  masons, 
especially  excited  me. 

"  Persons  in  my  own  position  had  hardly  any  effect  on  me ;  but,  at 
the  sight  of  one  of  those  strapping  fellows  of  the  lower  class,  I  experi- 
enced marked  sexual  excitement.  It  seems  to  me  that  the  touch  of  such 
trousers,  the  opening  of  them,  and  the  grasping  of  the  penis,  as  well  as 
kissing  the  fellow,  would  be  the  greatest  delight.  My  sensibility  to  female 
charms  is  somewhat  dulled ;  j-et  in  sexual  intercourse  with  a  woman,  par- 
ticularly when  she  has  well-developed  mammas,  I  am  alwaj's  potent 
without  the  help  of  imagination.  I  have  never  attempted  to  make  use 
of  a  young  laborer,  or  the  like,  for  the  satisfaction  of  my  evil  desires,  and 
never  shall;  but  I  often  feel  the  longing  to  do  it.  I  often  impress  on 
myself  the  mental  image  of  such  a  man,  and  then  masturbate  at  home. 

"  I  am  absolutely  devoid  of  taste  for  female  work.  I  rather  like  to 
move  in  female  society,  but  dancing  is  repugnant  to  me.  I  have  a  lively 
interest  in  the  fine  arts.  That  my  sexual  sense  is  partly  reversed  is,  I 
believe,  in  part  due  to  greater  convenience,  which  keeps  me  from  entering 
into  a  relation  with  a  girl ;  as  the  latter  is  a  matter  of  too  much  trouble. 
To  be  constantly  visiting  houses  of  prostitution  is,  for  aesthetic  reasons, 
repugnant  to  me ;  and  thus  I  am  always  returning  to  solitary  onanism, 
which  is  very  difficult  for  me  to  avoid. 

"  Hundreds  of  times  I  have  said  to  myself  that,  in  order  to  have  a 
normal  sexual  sense,  it  would  be  necessary  for  me,  first  of  all,  to  over- 
come my  irresistible  passion  for  onanism, — a  practice  so  repugnant  to  my 
aesthetic  feeling.  Again  and  again  I  have  resolved  with  all  my  might  to 
fight  this  passion  ;  but  I  am  still  unsuccessful.  When  I  felt  the  sexual 
impulse  gaining  strength,  instead  of  seeking  satisfaction  in  the  natural 


ACQUIRED   HOMO-SEXUALITY.  193 

manner,  I  preferred  to  masturbate,  because  I  felt  that  I  would  thus  have 
more  enjoyment. 

"  And  yet  experience  has  taught  me  that  I  am  alwa}'s  potent  with 
girls,  and  that,  too,  without  trouble  and  without  the  help  of  imagining  mas- 
culine genitals.  In  one  case,  however,  I  did  not  attain  ejaculation  because 
the  woman — it  was  in  a  brothel — was  devoid  of  every  charm.  I  cannot 
avoid  the  thought  and  severe  self-accusation  that,  to  a  certain  extent,  my 
contrary  sexuality  is  the  result  of  excessive  onanism  ;  and  this  especially 
depresses  me,  because  I  am  compelled  to  acknowledge  that  I  scarcely 
feel  strong  enough  to  overcome  this  vice  by  the  force  of  my  own  will. 

"  As  a  result  of  my  relations  with  my  fellow-student  and  school- 
mate for  }7ears,  mentioned  in  this  communication, — which,  however, 
began  while  we  were  at  the  University,  and  after  we  had  been  friends 
for  seven  years, — the  impulse  to  unnatural  satisfaction  of  libido  has 
grown  much  stronger.  I  trust  you  will  permit  the  description  of  an 
incident  which  occupied  me  for  months  : — 

"  In  the  summer  of  1882,  I  made  the  acquaintance  of  a  companion 
six  years  younger  than  myself,  who,  with  several  others,  had  been  intro- 
duced to  me  and  my  acquaintances.  I  very  soon  felt  a  deep  interest  in 
this  handsome  man,  who  was  unusually  well  proportioned,  slim,  and  full 
of  health.  After  a  few  weeks  of  association,  this  feeling  became  friend- 
ship, and  at  last  passionate  love,  with  feelings  of  the  most  intense  jealousy. 
I  very  soon  noticed  that,  in  this,  sexual  excitation  was  also  very  marked  ; 
and,  notwithstanding  my  determination,  aside  from  all  others,  to  keep 
myself  in  check  in  relation  to  this  man,  whom  I  respected  so  highly  for 
liis  superior  character,  one  night,  after  free  indulgence  in  beer,  as  we  were 
enjoying  a  bottle  of  champagne  in  my  room  and  drinking  to  good,  true, 
and  lasting  friendship,  I  yielded  to  the  irresistible  impulse  to  embrace 
him,  etc. 

"  When  I  saw  him,  next  day,  I  was  so  ashamed  that  I  could  not  look 
him  in  the  face.  I  felt  the  deepest  regret  for  my  action,  and  accused 
myself  bitterly  for  having  thus  sullied  this  friendship,  which  was  to  be 
and  remain  so  pure  and  precious.  In  order  to  prove  to  him  that  I  had 
lost  control  of  myself  only  momentarily,  at  the  end  of  the  semester  I 
urged  him  to  make  an  excursion  with  me  ;  and  after  some  reluctance,  the 
reason  of  which  was  only  too  clear  to  me,  he  consented.  Several  nights 
we  slept  in  the  same  room  without  any  attempt  on  m}r  part  to  repeat  my 
action.  I  wished  to  talk  with  him  about  the  event  of  that  night,  but  I 
could  not  bring  myself  to  it;  even  when,  during  the  next  semester, 
we  were  separated,  I  could  not  induce  myself  to  write  to  him  on  the 
subject;  and  when  I  visited  him,  in  March,  at  X.,  it  was  the  same.  And 
yet  I  felt  a  great  desire  to  clear  up  this  dark  point  by  an  open  statement. 
In  October  of  the  same  3rear,  I  was  again  in  X.,  and  this  time  found 
courage  to  speak  without  reserve  ;  indeed,  I  asked  him  why  he  had  not  re- 
sisted me.     He  answered  that,  in  part,  it  was  because  he  wished  to  please 


194  PSYCHOPATHIA   SEXUALIS. 

me,  and,  in  part,  owing  to  the  fact  that  he  was  somewhat  apathetic  as  a 
result  of  being  a  little  intoxicated.  I  explained  to  him  my  condition, 
and  also  gave  him  "  Psychopathia  Sexualis  "  to  read,  expressing  the  hope 
that  by  the  force  of  my  own  will  I  should  become  fully  and  lastingly 
master  of  my  unnatural  impulse.  Since  this  confession,  the  relation  be- 
tween this  friend  and  me  has  been  the  most  delightful  and  happ3r  possible ; 
there  are  the  most  friendly  feelings  on  both  sides,  which  are  heart-felt 
and  true;  and  it  is  to  be  hoped  that  they  will  endure. 

"  If  I  should  not  improve  my  abnormal  condition,  I  am  deter- 
mined to  put  myself  under  your  treatment ;  the  more  because,  after  a 
careful  study  of  your  work,  I  cannot  count  m3'self  as  belonging  to  the 
category  of  so-called  urnings;  and,  too,  because  I  have  the  firm  conviction, 
or  hope,  at  least,  that  a  strong  will,  assisted  and  combined  with  skillful 
treatment,  could  transform  me  into  a  man  of  normal  feeling." 

Case  95.  lima  S.,1  aged  29 ;  single ;  merchant's  daughter.  She  comes 
of  a  family  having  bad  nervous  taint.  Father  was  a  drinker  and  died  by 
suicide,  as  also  did  the  patient's  brother  and  sister.  A  sister  suffers  with 
convulsive  hysteria.  Mother's  father  shot  himself  while  insane.  Mother 
was  sickly,  and  died  paralyzed  after  apoplexy.  The  patient  never  had 
any  severe  illness.  She  is  bright,  enthusiastic,  and  dreamy.  Menses  at 
the  age  of  eighteen  without  difficulty ;  but  thereafter  they  were  very 
irregular.  At  fourteen,  chlorosis  and  catalepsy  from  fright.  Later,  hys- 
teria gravis  and  an  attack  of  hysterical  insanity.  At  eighteen,  relations 
with  a  young  man  which  were  not  platonic.  This  man's  love  was  pas- 
sionately returned.  From  statements  of  the  patient,  it  seems  that  she 
was  very  sensual,  and  after  separation  from  her  lover  practiced  mastur- 
bation. After  this  she  led  a  romantic  life.  In  order  to  earn  a  living,  she 
put  on  male  clothing,  and  became  a  tutor ;  but  she  gave  up  her  place  because 
her  mistress,  not  knowing  her  sex,  fell  in  love  with  her  and  courted  her. 
Then  she  became  a  railway-employe.  In  the  company  of  her  companions, 
in  order  to  conceal  her  sex,  she  was  compelled  to  visit  brothels  with  them, 
and  hear  the  most  vulgar  stories.  This  became  so  distasteful  to  her  that 
she  gave  up  her  place,  resumed  the  garments  of  a  female,  and  again 
sought  to  earn  her  living.  She  was  arrested  for  a  theft,  and  on  account 
of  severe  hystero-epilepsy  was  sent  to  the  hospital.  There,  inclination 
and  impulse  toward  the  same  sex  were  discovered.  The  patient  became 
troublesome  on  account  of  passionate  love  for  female  nurses  and  patients. 

Her  sexual  perversion  was  considered  congenital.  With  regard  to 
this  the  patient  made  some  interesting  statements : — 

"  I  am  judged  incorrectly,  if  it  is  thought  that  I  feel  myself  a  man 
toward  the  female  sex.  In  my  whole  thought  and  feeling  I  am  much 
more  a  woman.     I  loved  my  cousin  as  only  a  woman  can  love  a  man. 

1  Comp.  author '6  Experimental  Study  in  the  Domain  of  Hypnotism,  1889.  G.  P. 
Putnam's  Sons,  New  York. 


ACQUIRED   HOMOSEXUALITY.  195 

u  The  change  of  my  feeling  originated  in  this,  that,  in  Pesth,  dressed 
as  a  man,  I  had  an  opportunity  to  observe  my  cousin.  I  saw  that  I  had 
wholly  deceived  myself  in  him.  That  gave  me  terrible  heart-pangs.  I 
knew  that  I  could  never  love  another  man ;  that  I  belonged  to  those  who 
love  but  once.  Of  similar  effect  was  the  fact  that,  in  the  society  of  my 
companions  at  the  railway,  I  was  compelled  to  hear  the  most  offensive 
language  and  visit  the  most  disreputable  houses.  As  a  result  of  the  in- 
sight into  men's  motives,  gained  in  this  way,  I  took  an  unconquerable 
dislike  to  them.  However,  since  I  am  of  a  very  passionate  nature  and 
need  to  have  some  loving  person  on  whom  to  depend,  and  to  whom  I  can 
wholly  surrender  myself,  I  felt  myself  more  and  more  powerfully  drawn 
toward  intelligent  women  and  girls  who  were  in  sympathy  with  me." 

The  contrary  sexual  instinct  of  this  patient,  which  was 
clearly  acquired,  expressed  itself  in  a  stormy  and  decidedly 
sensual  way,  and  was  further  augmented  by  masturbation ;  be- 
cause constant  oversight  in  hospitals  made  sexual  satisfaction 
with  the  same  sex  impossible.  Character  and  occupation  re- 
mained feminine.  There  were  no  manifestations  of  viraginity. 
According  to  information  lately  received  by  the  author,  this 
patient,  after  two  years  of  treatment  in  an  asylum,  was  entirely 
freed  from  her  neurosis  and  sexual  perversion,  and  discharged 
cured. 

Case  96.  X.,  aged  19;  mother  nervous;  two  sisters  of  mother's 
father  were  insane.  Patient  of  nervous  temperament ;  well  endowed 
■  mentally  ;  well  developed ;  normally  formed.  When  he  was  twelve  years 
old,  he  was  seduced  into  mutual  onanism  by  an  elder  brother. 

After  this,  the  patient  continued  the  vice  alone.  In  the  last  three 
years,  during  the  act  of  masturbation,  he  had  had  peculiar  fancies  in  the 
sense  of  "contrary  sexual  instinct." 

He  fancies  himself  a  female  ;  as,  for  example,  a  ballet-dancer  in  the  act 
of  coitus  with  an  officer  or  circus  rider.  These  perverse  fancies  have  ac- 
companied the  act  of  masturbation  since  the  patient  became  neurasthenic. 
He  understands  the  harm  of  masturbation,  fights  desperately  against  it, 
but  always  gives  up  to  the  impulse. 

If  he  is  able  to  withstand  the  impulse  for  a  few  days,  a  normal  desire 
for  sexual  intercourse  with  females  is  awakened ;  but  a  certain  fear  of 
infection  holds  these  desires  in  check,  and  always  drives  him  again  to 
masturbation. 

It  is  worthy  of  remark  that  this  unfortunate's  lascivious  dreams 
concerned  only  females. 

In  the  course  of  the  last  few  months,  the  patient  had  become  very 
neurasthenic  and  hypochondriacal.     He  feared  tabes. 


196  PSYCHOPATHIA    SEXUALIS. 

I  advised  treatment  of  the  neurasthenia,  suppression  of  mastur- 
bation, and  marital  cohabitation,  if  possible,  after  improvement  of  the 
neurasthenia. 

Case  97.  Mr.  X,  aged  35,  single,  official ;  mother  insane,  brother 
hypochondriacal. 

Patient  was  healthy,  strong,  of  lively  sensual  temperament.  He 
had  manifested  powerful  sexual  instinct  abnormally  early,  and  mastur- 
bated while  yet  a  small  boy.  He  had  coitus  the  first  time  at  the  age  of 
fourteen,  he  saj's,  witli  enjoyment  and  complete  power.  When  fifteen 
years  old,  a  man  sought  to  seduce  him,  and  performed  manustupration 
on  him.  X.  experienced  a  feeling  of  repulsion,  and  freed  himself  from 
the  disgusting  situation.  At  maturity  he  committed  excesses  in  libido, 
with  coitus ;  in  1880  he  became  neurasthenic,  being  afflicted  with  weak- 
ness of  erection  and  ejaculatio  praecox.  He  thus  became  less  and  less 
potent,  and  no  longer  experienced  pleasure  in'  the  sexual  act.  At  this 
time  of  sexual  decadence,  for  a  long  time,  he  still  had  what  was  previ- 
ously foreign  to  him,  and  is  still  incomprehensible  to  him, — an  inclina- 
tion for  sexual  intercourse  with  immature  girls  of  the  age  of  twelve  or 
thirteen.     His  libido  increased  as  virility  diminished. 

Gradually  lie  developed  inclination  for  boys  of  thirteen  or  fourteen. 
He  was  impelled  to  approach  them. 

Quodsi  ei  occasio  data  est  ut  tangere  posset  pueros  qui  ei  placuere, 
penis  vehementer  se  erexit  turn  maxime  quum  crura  puerorum  tangere 
potuisset.  Abhinc  feminas  non  cupivit.  Nonnunquam  feminas  ad  eoitum 
coegit  sed  erectio  debilis,  ejaculatio  prematura  erat  sine  ulla  voluptate. 

Now  only  youths  interested  him.  He  dreamed  about  them  and  had 
pollutions.  After  1882  he  now  and  then  had  opportunity  concumbere 
cum  juvenibus.  This  led  to  powerful  sexual  excitement,  which  he  satis-- 
fled  by  masturbation.  It  was  only  exceptional  for  him  to  venture  to 
touch  his  bed-fellow  and  indulge  in  mutual  masturbation.  He  shunned 
pederasty.  For  the  most  part,  he  was  compelled  to  satisfy  his  sexual 
needs  by  means  of  solitary  masturbation.  In  the  act  he  called  up  the 
vision  of  pleasing  boys.  After  sexual  intercourse  with  such  boys,  he 
always  felt  strengthened  and  refreshed,  but  morally  depressed ;  because 
there  was  consciousness  of  having  performed  a  perverse,  indecent,  and 
punishable  act.  He  found  it  painful  that  his  disgusting  impulse  was 
more  powerful  than  his  will. 

X.  thinks  that  his  love  for  his  own  sex  has  resulted  from  great 
excess  in  natural  sexual  intercourse,  and  bemoans  his  situation.  On  the 
occasion  of  a  consultation,  in  December,  1889,  he  asked  whether  there 
were  any  means  to  bring  him  back  to  a  normal  sexual  condition,  since  he 
had  no  real  horror  feminae,  and  would  very  gladly  marry. 

This  intelligent  patient,  free  from  degenerative  signs,  presented  no 
abnormal  symptoms  except  those  of  sexual  and  spinal  neurasthenia  of 
moderate  degree. 


ACQUIRED   HOMOSEXUALITY.  197 

II.  Degree:  Eviration  and  Defemination. — If,  in  cases  of 
contrary  sexual  instinct  thus  developed,  no  restoration  occurs, 
then  deep  and  lasting  transformations  of  the  psychical  person- 
ality may  occur.  The  process  completing  itself  in  this  way  may 
be  briefly  designated  eviration.  The  patient  undergoes  a  deep 
change  of  character,  particularly  in  his  feelings  and  inclinations, 
which  become  those  of  a  female.  After  this,  he  also  feels  him- 
self to  be  a  woman  during  the  sexual  act,  has  desire  only  for 
passive  sexual  indulgence,  and,  under  certain  circumstances, 
sinks  to  the  level  of  a  prostitute.  In  this  condition  of  deep 
and  more  lasting  psycho-sexual  transformation,  the  individual 
is  like  the  (congenital)  urning  of  high  grade.  The  possibility 
of  a  restoration  of  the  previous  mental  and  sexual  personality 
seems,  in  such  a  case,  excluded. 

The  following  case  is  a  classical  example  of  this  variety  of 
lasting  acquired  contrary  sexual  instinct: — 

Case  98.  Sch.,  aged  30,  physician,  one  day  told  me  the  story  of  his 
life  and  malady,  asking  explanation,  and  advice  concerning  certain  anom- 
alies of  his  vita  sexualis.  The  following  description  gives,  for  the  most 
part  verbatim,  the  details  of  the  autobiography ;  only  in  some  portions  is 
it  shortened : — 

"  My  parents  were  healthy.  As  a  child  I  was  sickly ;  but  with 
good  care  I  thrived,  and  got  on  well  in  school.  When  eleven  years  old,  I 
was  taught  to  masturbate  by  my  playmates,  and  gave  myself  up  to  it  pas- 
sionately. Until  I  was  fifteen,  I  learned  easily.  On  account  of  frequent 
pollutions,  I  became  less  capable,  did  not  get  on  easily  in  school,  and  was 
uncertain  and  embarrassed  when  called  on  by  the  teacher.  Frightened 
by  my  loss  of  capability,  and  recognizing  that  the  loss  of  semen  was 
responsible  for  it,  I  gave  up  masturbation  ;  but  the  pollutions  became 
even  more  frequent,  so  that  I  often  had  two  or  three  in  a  night.  In 
despair,  I  now  consulted  one  physician  after  another.  None  were  able 
to  help  me. 

"  Since  I  grew  weaker  and  weaker,  by  reason  of  the  loss  of  semen, 
with  the  impulse  to  sexual  satisfaction  growing  more  and  more  pow- 
erful, I  sought  houses  of  prostitution.  But  I  was  there  unable  to  find 
satisfaction ;  for,  even  though  the  sight  of  a  naked  female  pleased  me, 
neither  orgasm  nor  erection  occurred ;  and  even  manustupration  by  the 
puella  was  not  capable  of  inducing  erection.  Scarcely  would  I  leave 
the  house,  when  the  impulse  would  seize  me  again,  and  I  would  have  vio- 
lent erections.  I  grew  ashamed  before  the  girls,  and  ceased  to  visit  such 
houses.     Thus  a  couple  of  years  passed.     My  sexual  life  consisted  of 


198  PSTCHOPATHIA   SEXUALlS. 

pollutions.  My  inclination  toward  the  opposite  sex  grew  less  and  less. 
At  nineteen  I  went  to  the  University.  The  theatre  had  more  attractions 
for  me.  I  wished  to  become  an  actor.  My  parents  were  not  willing.  At 
the  Capital  I  was  compelled  now  and  then  to  visit  girls  with  my  com- 
rades. I  feared  such  a  situation ;  because  I  knew  that  coitus  was  impos- 
sible for  me,  and  because  my  friends  might  discover  my  impotence. 
Therefore,  I  avoided,  as  far  as  possible,  the  danger  of  becoming  the  butt 
of  jokes  and  ridicule. 

"  One  evening,  in  the  opera-house,  an  old  gentleman  sat  near  me. 
He  courted  me.  I  laughed  heartily  at  the  foolish  old  man,  and  eut  3red 
into  his  joke.  Exinapinato  genitalia  mea  prehendit,  quo  facto  stitim 
penis  meus  se  erexit.  Frightened,  I  demanded  of  him  what  he  meant. 
He  said  that  he  was  in  love  with  me.  Having  heard  of  hermaphrodites 
in  the  clinics,  I  thought  I  had  one  before  me,  and  became  curious  to  see 
his  genitals.  The  old  man  was  very  willing,  and  went  with  me  to  the 
water-closet.  Sicuti  penem  maximum  ejus  erectum  adspexi,  perter- 
ritus  effugi. 

"  This  man  followed  me,  and  made  strange  proposals  which  I  did  not 
understand,  and  repelled.  He  did  not  give  me  any  rest.  I  learned  the 
secrets  of  male  love  for  males,  and  felt  that  my  sexuality  was  excited  by 
it.  But  I  resisted  the  shameful  passion  (as  I  then  regarded  it),  and,  for 
the  next  three  years,  I  remained  free  from  it.  During  this  time  I  repeat- 
edly attempted  coitus  with  girls  in  vain.  My  attempts  to  free  myself  of 
my  impotence  by  means  of  medical  treatment  were  also  vain.  Once, 
when  my  libido  sexualis  was  troubling  me  again,  I  recalled  what  the  old 
man  had  told  me :  that  male-loving  men  were  accustomed  to  meet  on  the 
E.  Promenade. 

"  After  a  hard  struggle,  and  with  beating  heart,  I  went  there,  made 
the  acquaintance  of  a  blonde  man,  and  allowed  myself  to  be  seduced. 
The  first  step  was  taken.  This  kind  of  sexual  love  was  satisfactory  to 
me.  I  always  preferred  to  be  in  the  arms  of  a  strong  man.  The  satis- 
faction consisted  of  mutual  manustupration ;  occasionally  in  osculum  ad 
penem  alterius.  I  was  then  twenty-three  years  old.  Sitting,  together 
with  my  comrades,  on  the  beds  of  patients  in  the  clinic  during  the  lec- 
tures, excited  me  so  intensely  that  I  could  scarcely  listen  to  the  lectures. 
In  the  same  year  I  entered  into  a  formal  love-relation  with  a  merchant 
of  thirty-four.  We  lived  as  man  and  wife.  X.  played  the  man,  and  fell 
more  and  more  in  love.  I  gave  up  to  him,  but  now  and  then  I  had  to 
play  the  man.  After  a  time  I  grew  tired  of  him,  became  unfaithful,  and 
he  became  jealous.  There  were  terrible  scenes,  which  led  to  temporary 
separation,  and  finally  to  actual  rupture.  (The  merchant  afterward 
became  insane,  and  died  by  suicide.) 

"  I  made  many  acquaintances,  and  loved  the  most  ordinary  people. 
I  preferred  those  having  a  full  beard,  and  who  were  tall  and  of  middle  age, 
and  able  to  play  the  active  role  well.     I  developed  a  proctitis.     The  pro- 


ACQUIRED   HOMO-SEXUALITY.  199 

fessor  thought  it  was  the  result  of  sitting  too  much  while  preparing  for 
examinations.  I  developed  a  fistula,  and  had  to  undergo  an  operation ; 
but  this  did  not  cure  me  of  my  desire  to  allow  myself  to  be  used  passively. 
I  became  a  physician,  and  went  to  a  provincial  city,  where  I  had  to  live 
like  a  nun.  I  developed  a  desire  to  move  in  ladies'  society,  and  was 
gladly  welcomed  there ;  because  it  was  found  that  I  was  not  so  one-sided 
as  most  men,  and  was  interested  in  toilettes  and  such  feminine  things. 
However,  I  felt  very  unhappy  and  lonesome.  Fortunately,  in  this  town, 
I  made  the  acquaintance  of  a  man,  a '  sister,'  who  felt  like  me.  For  some 
time  I  was  taken  care  of  by  him.  When  he  had  to  leave,  I  had  an 
attack  of  despair,  with  depression,  which  was  accompanied  by  thoughts 
of  suicide. 

"  When  it  became  impossible  for  me  to  longer  endure  the  town,  I 
became  a  military  surgeon  in  the  Capital.  There  I  began  to  live  again, 
and  often  made  two  or  three  acquaintances  in  one  day.  I  had  never 
loved  boys  or  young  people ;  only  fully-developed  men.  The  thought  of 
falling  into  the  hands  of  the  police  was  frightful.  Thus  I  have  escaped 
the  clutches  of  the  blackmailer.  At  the  same  time,  I  could  not  keep 
myself  from  the  satisfaction  of  my  impulse.  After  some  months  I  fell  in 
love  with  an  official  of  forty.  I  remained  true  to  him  for  a  year,  and  we 
lived  like  a  pair  of  lovers.  I  was  the  wife,  and  was  formally  courted  by 
the  lover.  One  day  I  was  transferred  to  a  small  town.  We  were  in 
despair.  The  last  night  was  spent  in  continually  kissing  and  caressing 
one  another. 

"  In  T.  I  was  unspeakably  unhappy,  in  spite  of  some  '  sisters'  whom 
I  found.  I  could  not  forget  my  lover.  In  order  to  satisfy  my  sexual 
desire,  which  cried  for  satisfaction,  I  chose  soldiers.  Money  obtained 
men ;  but  they  remained  cold,  and  I  had  no  enjoyment  with  them.  I  was 
successful  in  being  re-transferred  to  the  Capital.  There,  there  was  a  new 
love-relation,  but  much  jealousy ;  because  my  lover  liked  to  go  into  the 
society  of  '  sisters,'  and  was  proud  and  coquettish.  There  was  a  rupture. 
I  was  very  unhappy  and  very  glad  to  be  transferred  from  the  Capital.  I 
now  stayed  in  C,  alone  and  in  despair.  Two  infantry  privates  were 
brought  into  service,  but  with  the  same  unsatisfactory  result.  When 
shall  I  ever  find  true  love  again  ? 

"  I  am  over  medium  height,  well  developed,  and  look  somewhat 
aged ;  and,  therefore,  when  I  wish  to  make  conquests  I  use  the  arts  of  the 
toilet.  My  manner,  movements,  and  face  are  masculine.  Physically  I 
feel  as  youthful  as  a  boy  of  twenty.  I  love  the  theatre,  and  especially 
art.  My  interest  in  the  stage  is  in  the  actresses,  whose  every  move- 
ment and  gesture  I  notice  and  criticise. 

"  In  the  society  of  gentlemen  I  am  silent  and  embarrassed,  while 
in  the  society  of  those  like  myself  I  am  free,  witty,  and  as  fawning  as  a 
cat,  if  a  man  is  sympathetic.  If  I  am  without  love,  I  become  deeply 
melancholic  ;  but  the  favors  of  the  first  handsome  man  dispel  my  depres- 


200  PSYCHOPATHIA   SEXUALIS. 

sion.  In  other  ways  I  am  frivolous ;  anything  but  ambitious.  My 
profession  is  nothing  to  me.  Masculine  pursuits  do  not  interest  me. 
I  prefer  novels  and  going  to  the  theatre.  I  am  effeminate,  sensitive, 
easily  moved,  easily  injured,  and  nervous.  A  sudden  noise  makes  my 
whole  body  tremble,  and  I  have  to  collect  myself  in  order  to  keep  from 
crying  out." 

Remarks:  The  foregoing  case  is  certainly  one  of  acquired  con- 
trar}-  sexual  instinct,  since  the  sexual  instinct  and  impulse  were  origi- 
nally directed  toward  the  female  sex.  Sch.  became  neurasthenic  through 
masturbation. 

As  an  accompanying  manifestation  of  the  neurasthenic  neurosis, 
lessened  impressionability  of  the  erection-centre  and  consequent  rela- 
tive impotence  came  on.  As  a  result  of  this,  sexual  sensibility  toward 
the  opposite  sex  was  lessened,  with  simultaneous  persistence  of  libido 
sexualis.  The  acquired  contrary  sexual  instinct  must  be  abnormal,  since 
the  first  touch  by  a  person  of  the  same  sex  is  an  adequate  stimulus  for 
the  erection-centre.  The  perverse  sexual  feeling  became  complete.  At 
first  Sch.  felt  like  a  man  in  the  sexual  act ;  but  more  and  more,  as  the 
change  progressed,  the  feeling  and  desire  of  satisfaction  changed  to  the 
form  which,  as  a  rule,  characterizes  the  (congenital)  urning. 

This  eviration  induces  a  desire  for  the  passive  role,  and,  further,  for 
(passive)  pederasty.  It  makes  a  deeper  impress  on  the  character.  The 
character  becomes  feminine,  inasmuch  as  Sch.  now  prefers  to  move  in  the 
society  of  actual  females,  has  an  increasing  desire  for  feminine  occupa- 
tions, and,  indeed,  makes  use  of  the  arts  of  the  toilet  in  order  to  improve 
his  fading  charms  and  make  "  conquests." 

The  foregoing  facts,  concerning  acquired  contrary  sexual 
instinct  and  effemination,  find  an  interesting  confirmation  in  the 
following  ethnological  data : — 

Even  Herodotus  describes  a  peculiar  disease  which  frequently 
affected  the  Scythians.  The  disease  consisted  in  this  :  that  men  became 
effeminate  in  character,  put  on  female  garments,  did  the  work  of 
women,  and  even  became  effeminate  in  appearance.  As  an  explanation 
of  this  insanity  of  the  Scythians,1  Herodotus  relates  the  myth  that 
the  goddess  Venus,  angered  by  the  plundering  of  the  temple  at  Ascalon 
by  the  Scythians,  had  made  women  of  these  plunderers  and  their 
posterity. 

1  Comp.  Sprengel,  "  Apologie  des  Hippokrates,"  Leipzig,  1792,  p.  611 ;  Friedreich, 
"  Literargeschichte  der  psych.  Krankheiten,"  1830,  p.  31  ;  Lallcmand,  "Des  pertes  s6nii- 
nales,"  Paris,  1836,  i,  p.  581 ;  Nysten,  "  Dietionn.  de  m6decine,"  xi  edit.,  Paris,  1858,  Art. 
"  6viration  et  Maladie  des  Scythes  "  ;  Marandon,  "  De  la  maladie  des  Scythes";  "Annal. 
m6dico-psychol.,"  1877,  Mars,  p.  161;  Hammond,  Americau  Journal  of  Neurology  aud 
Psychiatry,  August,  1882. 


ACQUIRED   HOMOSEXUALITY.  201 

Hippocrates,  not  believing  in  supernatural  diseases,  recognized 
that  impotence  was  here  a  causative  factor,  and  explained  it,  though  in- 
correctly, as  due  to  the  custom  of  the  Sc}Tthians,  by  attributing  it  to  dis- 
ease of  the  jugular  veins  induced  by  excessive  riding.  He  thought  that 
these  veins  were  of  great  importance  in  the  preservation  of  the  sexual 
powers,  and  that  when  they  were  severed,  impotence  was  induced.  Since 
the  Scythians  considered  their  impotence  due  to  divine  punishment,  and 
incurable,  they  put  on  the  clothing  of  females,  and  lived  as  women  among 
women. 

It  is  worthy  of  note  that,  according  to  Klaproth  ("  Reise  in  den 
Kaukasus,"  Berlin,  1812,  v,  p.  285)  and  Chotomski,  even  at  the  present 
time  impotence  is  very  frequent  among  the  Tartars,  as  a  result  of  riding 
unsaddled  horses.  The  same  is  observed  among  the  Apaches  and  Nava- 
jos  of  the  Western  Continent,  who  ride  excessively,  scarcely  ever  going 
on  foot,  and  are  remarkable  for  small  genitals  and  mild  libido  and 
virility.  Sprengel,  Lallemand,  and  Nysten  recognized  the  fact  that  ex- 
cessive riding  may  be  injurious  to  the  sexual  organs. 

Hammond  reports  analogous  observations  of  great  interest  con- 
cerning the  Pueblo  Indians  of  New  Mexico.  These  descendants  of  the 
Aztecs  cultivate  so-called  "  mujerados,"  of  which  every  Pueblo  tribe  re- 
quires one  in  the  religious  ceremonies  (actual  orgies  in  the  spring),  in 
which  pederasty  plays  an  important  part.  In  order  to  cultivate  a  "  mu- 
jerado,"  a  very  powerful  man  is  chosen,  and  he  is  made  to  masturbate  ex- 
cessively and  ride  constantly.  Gradually  such  irritable  weakness  of  the 
genital  organs  is  engendered  that,  in  riding,  great  loss  of  semen  is  induced. 
This  condition  of  irritability  passes  into  paralytic  impotence.  Then  the 
testicles  and  penis  atrophy,  the  hair  of  the  beard  falls  out,  the  voice  loses 
its  depth  and  compass,  and  physical  strength  and  energy  decrease.  In- 
clinations and  disposition  become  feminine.  The  "  mnjerado  "  loses  his 
position  in  society  as  a  man.  He  takes  on  feminine  manners  and  customs, 
and  associates  with  women.  Yet,  for  religious  reasons,  he  is  held  in 
honor.  It  is  probable  that,  at  other  times  than  during  the  festivals,  he 
is  used  by  the  chiefs  for  pederasty.  Hammond  had  an  opportunity  to  ex- 
amine two  "  mujerados."  One  had  become  such  seven  years  before,  and 
was  thirty -five  years  old  at  the  time.  Seven  years  before,  he  was  entirely 
masculine  and  potent.  He  had  noticed  gradual  atrophy  of  the  testicles 
and  penis.  At  the  same  time  he  lost  libido  and  the  power  of  erection. 
He  differed  in  nowise,  in  dress  and  manner,  from  the  women  among 
whom  Hammond  found  him.  The  genital  hair  was  wanting,  the  penis 
was  shrunken,  the  scrotum  lax  and  pendulous,  and  the  testicles  were 
very  much  atrophied  and  no  longer  sensitive  to  pressure.  The 
"mnjerado"  had  large  mammae  like  a  pregnant  woman,  and  asserted 
that  he  had  nursed  several  children  whose  mothers  had  died.  A 
second  "mnjerado,"  aged  thirty-six,  after  he  had  been  ten  }-ears  in 
the  condition,  presented  the   same  peculiarities,  though  with  less  de- 


202  PSYCHOPATHIA   SEXUALIS. 

velopment  of  mammae.     Like  the  first,  the  voice  was   high   and   thin. 
The  body  was  plump.1 

III.     Degree:    Stage  of    Transition   to   Metamorphosis 
Sexualis  Paranoica. 

A  further  degree  of  development  is  represented  by  those 
cases  in  which  bodily  sensation  is  also  transformed  in  the  sense 
of  a  transmutatio  sexus.  In  this  respect  the  following  case  is 
unique : — 

1  The  following  description  of  the  "bote"  is  taken  from  Dr.  J.  G.  Kiernan's  article 
on  "  Responsibility  in  Sexual  Perversion,"  read  before  the  Chicago  Medical  Society,  March  7, 
1892  :  "  In  accordance  with  the  well-known  physiological  law,  that  too  frequent  excitation 
of  a  nerve  exhausts  the  reaction  of  that  nerve  to  that  excitant,  sexual  excess  exhausts  the 
normal  reaction,  whence  it  occurs  that  abnormal  stimulus  is  required  and  the  vice  type  of 
sexual  perversion  results.  Such  vice  types  crop  up  among  savages.  Dr.  A.  B.  Holder  (N. 
Y.  Med.  Jour.,  1889)  describes  a  sexual  pervert  called  the  'bote'  by  the  Montana  and  the 
'burdach '  by  the  Washington  Indians.  Such  a  pervert  is  found  among  all  the  tribes  of  the 
Northwest.  Like  all  other  sexual  perverts,  these  '  botes '  can  recognize  each  other.  Dr. 
Holder  has  found  that  the  '  bote  '  wears  the  squaw  dress,  parts  his  hair  like  a  squaw,  and 
assumes  femiuine  speech  and  manners.  Their  features  are  often  masculine.  In  childhood 
feminine  dress  and  manners  are  assumed,  but  not  until  puberty  do  'bote '  practices  result. 
These  consist  in  taking  the  male  organ  of  the  active  party  in  the  lips  of  the  '  bote,'  who 
experiences  the  sexual  orgasm  at  the  same  time.  A  '  bote '  examined  by  Dr.  Holder  was  a 
splendidly  formed  fellow,  of  prepossessing  face,  in  perfect  health,  active  in  movement,  and 
happy  in  disposition.  By  offering  payment,  he  induced  him  to  submit  himself,  though  with 
considerable  reluctance,  to  a  thorough  examination.  He  was  five  feet  eight  inches  high, 
weighed  one  hundred  and  fifty-eight  pounds,  and  had  a  frank,  intelligent  face, — being  an 
Indian,  of  course  beardless.  He  was  thirty-three  years  of  age,  and  had  worn  woman's 
dress  for  twenty-eight  years.  His  dress  was  the  usual  dress  of  the  Indian  female,  consist- 
ing of  four  articles, — a  single  dress  or  gown  of  half  a  dozen  yards  of  cloth,  made  loose 
with  wide  sleeves,  and  skirt  reaching  to  the  ankles,  the  skirt  and  body  of  one  piece,  very 
much  like  the  '  Mother  Hubbard '  negligee  worn  by  ladies  ;  a  beaded  belt  loosely  confining 
this  at  the  waist ;  stockings  from  government  annuity  goods,  and  buckskin  moccasins 
extending  above  the  ankles.  The  hair,  twenty-four  or  twenty-six  inches  long,  was  parted 
in  the  centre  and  allowed  to  hang  loose  in  two  masses  behind  the  shoulders.  Since  among 
the  Sioux  and  some  other  tribes  it  is  usual  for  men  to  wear  their  hair  in  this  way,  it  is  well 
to  observe  that  in  this  tribe  (Absaroke)  the  men  usually  wear  the  hair  in  long  braids,  and 
always  part  it  on  the  side  and  '  roach '  the  front.  His  skin  was  smooth  and  free  from  hair, 
there  being  absolutely  none  on  the  legs,  arms,  or  breast,  or  in  the  arm-pits.  This  is  of  no 
special  significance,  as  male  and  female  Indians  are  both  free  from  hair  on  these  parts  of  the 
body.  The  mammae  were  as  rudimentary  as  those  of  the  male.  When  he  removed  his  dress 
he  threw  his  thighs  together  so  as  to  completely  conceal  the  organs,  whether  male  or  female ; 
such  a  movement  is  made  by  timid  women  under  examination, — a  movement  usually  suc- 
cessful in  the  female,  owing  to  the  non-projecting  character  of  the  genitals  and  to  the 
rotundity  of  the  thighs  ;  but  not  usually  easy,  for  the  reverse  reasons,  in  the  male.  In  this 
the  '  bote ' — either  from  the  conformation  of  the  thighs,  which  had  the  feminine  rotundity, 
or  from  skill  acquired  by  habit — succeeded  completely.  When  he  separated  his  thighs, 
male  organs  came  into  view,  in  size  perhaps  not  quite  so  large  as  the  physique  of  the  man 
would  indicate,  but  in  position  and  shape  altogether  normal.  The  penis  was  flaccid.  The 
'  bote '  in  habits  very  closely  resembles  a  class  described  by  Hippocrates  among  the  Scyth- 
ians of  Caucasus,  called  by  the  Greeks  anandreis,  a  word  strikingly  similar  in  meaning  to 
'bote.'"— Trans. 


ACQUIRED   HOMO-SEXUALITY.  203 

Case' 99.  Autobiography.  "Born  in  Hungary  in  1844,  for  many- 
years  I  was  the  only  child  of  my  parents  ;  for  the  other  children  died  for 
the  most  part  of  general  weakness.  A  brother  came  late,  who  is  still 
living. 

"  I  come  of  a  family  in  which  nervous  and  mental  diseases  have 
been  numerous.  It  is  said  that  I  was  very  pretty  as  a  little  child,  with 
blonde  locks  and  transparent  skin  ;  very  obedient,  quiet,  and  modest,  so 
that  I  was  taken  everywhere  in  the  society  of  ladies  without  any  offense 
on  my  part. 

"  With  a  very  active  imagination — my  enemy  through  life — my 
talents  developed  rapidly.  I  could  read  and  write  at  the  age  of  four; 
my  memory  reaches  back  to  my  third  year.  I  pLnyed  with  everything 
that  fell  into  my  hands, — with  leaden  soldiers,  or  stones,  or  ribbons  from 
a  children's  store;  but  a  machine  for  working  in  wood,  that  was  given 
to  me  as  a  present,  I  did  not  like.  I  liked  best  to  be  at  home  with  my 
mother,  who  was  everything  to  me.  I  had  two  or  three  friends,  with  whom 
I  got  on  good-naturedly  ;  but  I  liked  to  play  with  their  sisters  quite 
as  well,  who  always  treated  me  like  a  girl,  which  at  first  did  not  embar- 
rass me.  I  must  have  already  been  on  the  road  to  become  just  like  a 
girl ;  at  least,  I  can  still  well  remember  how  it  was  always  said  :  '  He  is 
not  intended  for  a  boy.'  At  this  I  tried  to  play  the  boy, — imitated  my 
companions  in  everything,  and  tried  to  surpass  them  in  wildness.  In 
this  I  succeeded.  There  was  no  tree  or  building  too  high  for  me  to 
reach  its  top.  I  took  great  delight  in  soldiers.  I  avoided  girls  more, 
because  I  did  not  wish  to  play  with  their  play-things ;  and  it  alwa}rs 
annoyed  me  that  they  treated  me  so  much  like  one  of  themselves. 

"  In  the  society  of  mature  people,  however,  I  was  always  modest, 
and,  also,  always  regarded  with  favor.  Fantastic  dreams  about  wild 
animals — which  once  drove  me  out  of  bed  without  waking  me — fre- 
quently troubled  me.  I  was  alwa3rs  very  simply,  but  very  elegantly, 
dressed,  and  thus  developed  a  taste  for  beautiful  clothing.  It  seems 
peculiar  to  me  that,  from,  the  time  of  my  school-days,  I  had  a  partiality 
for  ladies'  gloves,  which  I  put  on  secretly  as  often  as  I  could.  Thus, 
when  once  my  mother  was  about  to  give  away  a  pair  of  gloves,  I  made 
great  opposition  to  it,  and  told  her,  when  she  asked  why  I  acted  so,  that 
I  wanted  them  myself.  I  was  laughed  at ;  and  from  that  time  I  took 
good  care  not  to  display  my  preference  for  female  things.  Yet  ni3r 
delight  in  them  was  very  great.  I  took  especial  pleasure  in  masquerade 
costumes, — i.e.,  only  in  female  attire.  If  I  saw  them,  I  envied  their 
owners.  What  seemed  to  me  the  prettiest  sight  was :  two  young  men, 
beautifully  dressed  as  white  ladies,  with  masks  on;  and  yet  I  would  not 
have  shown  n^-self  to  others  as  a  girl  for  anything ;  I  was  so  afraid  of 
being  ridiculed.  At  school  I  worked  very  hard,  and  was  always  among 
the  first.  From  childhood  my  parents  taught  me  that  duty  came  first; 
and  they  always  set  me  an  example.     It  was  also  a  pleasure  for  me  to 


204  PSYCHOPATHIA   SEXtJALlS. 

attend  school;  for  the  teachers  were  kind, and  the  elder  scholars  did  not 
plague  the  younger  ones.  We  left  my  first  home ;  for  my  father  was 
compelled,  on  account  of  his  business, — which  was  dear  to  him, — to  sep- 
arate from  his  family  for  a  year.  We  moved  to  Germany.  Here  there 
was  a  stricter,  rougher  manner,  partly  in  teachers  and  partly  in  scholars  ; 
and  I  was  again  ridiculed  on  account  of  my  girlishness.  My  school- 
mates went  so  far  as  to  give  a  girl,  who  had  exactly  my  features,  my 
name,  and  me  hers ;  so  that  I  hated  the  girl.  But  I  later  came  to  be  on 
terms  of  friendship  with  her  after  her  marriage.  My  mother  tried  to 
dress  me  elegantly  ;  but  this  was  repugnant  to  me,  because  it  made  me  the 
object  of  joke.  So,  finally,  I  was  delighted  when  I  had  correct  trousers 
and  coats.  But  with  these  came  a  new  annoyance.  They  irritated  my 
genitals,  particularly  when  the  cloth  was  rough ;  and  the  touch  of  tailors 
while  measuring  me,  on  account  of  their  tickling,  which  almost  con- 
vulsed me,  was  unendurable,  particularly  about  the  genitals.  Then  I 
had  to  practice  gymnastics  ;  and  I  simply  could  do  nothing  at  all,  or  only 
indifferently  the  things  that  girls  cannot  do  easily.  While  bathing  I 
was  troubled  by  feeling  ashamed  to  undress ;  but  I  liked  to  bathe.  Until 
my  twelfth  year  I  had  a  great  weakness  in  my  back.  I  learned  to  swim 
late,  but  ultimately  so  well  that  I  took  long  swims.  At  thirteen  I  had 
pubic  hair,  and  was  about  six  feet  tall ;  but  m}'  face  was  feminine  until 
my  eighteenth  year,  when  my  beard  came  in  abundance  and  gave  me  rest 
from  resemblance  to  woman.  An  inguinal  hernia  that  was  acquired  in 
my  twelfth  year,  and  cured  when  I  was  twenty,  gave  me  much  trouble, 
particularly  in  gymnastics.  Besides,  from  my  twelfth  year  on,  I  had, 
after  sitting  long,  and  particularly  while  working  at  night,  an  itching, 
burning,  and  twitching,  extending  from  the  penis  to  my  back,  which  the 
acts  .of  sitting  and  standing  increased,  and  which  was  made  worse  by 
catching  cold.  But  I  had  no  suspicion  whatever  that  this  could  be 
connected  with  the  genitals.  Since  none  of  m}7  friends  suffered  in  this 
way,  it  seemed  strange  to  me ;  and  it  required  the  greatest  patience  to 
endure  it;  the  more  owing  to  the  fact  that  m}',  abdomen  troubled  me. 

"  In  aexualibus  I  was  still  perfectly  innocent ;  but  now,  as  at  the 
age  of  twelve  or  thirteen,  I  had  a  definite  feeling  of  preferring  to  be  a 
young  lady.  A  young  lady's  form  was  more  pleasing  to  me;  her  quiet 
manner,  her  deportment,  but  particularly  her  attire,  attracted  me.  But 
I  was  careful  not  to  allow  this  to  be  noticed ;  and  yet,  I  am  sure  that  I 
should  not  have  shrunk  from  the  castration-knife,  could  I  have  thus 
attained  my  desire.  If  I  had  been  asked  to  say  why  I  preferred  female 
attire,  I  could  have  said  nothing  more  than  that  it  attracted  me  power- 
fully;  perhaps,  too,  I  seemed  to  myself,  on  account  of  my  uncommonly 
white  skin,  more  like  a  girl.  The  skin  of  my  face  and  hands,  particu- 
larly, was  very  sensitive.  Girls  liked  my  society;  and,  though  I  should 
have  preferred  to  have  been  with  them  constantly,  I  avoided  them  when 
I  could  ;  for  I  had  to  exaggerate  in  order  not  to  appear  feminine.     In 


ACQUIRED    HOMOSEXUALITY.  205 

my  heart  I  always  envied  them.  I  was  particularly  envious  when  one 
of  my  young  girl  friends  got  long  dresses  and  wore  gloves  and  veils. 
When,  at  the  age  of  fifteen,  I  was  on  a  journey,  a  young  lady,  with  whom 
I  was  boarding,  proposed  that  I  mask  as  a  lady  and  go  out  with  her;  but, 
owing  to  the  fact  that  she  was  not  alone,  I  did  not  acquiesce,  much  as  I 
should  have  liked  it.  Others  stood  on  very  little  ceremony  with  me. 
While  on  this  journey,  I  was  pleased  at  seeing  boys  in  one  city  wearing 
blouses  with  short  sleeves,  and  the  arms  bare.  A  lady  elaborately 
dressed  was  like  a  goddess  to  me ;  and  if  even  her  hand  touched  me 
coldly  I  was  happy  and  envious,  and  only  too  gladly  would  have  put 
myself  in  her  place  in  the  beautiful  garments  and  lovely  form.  Never- 
theless, I  studied  assiduously,  and  passed  through  the  Realschule  and 
the  Gymnasium  in  nine  years,  passing  a  good  final  examination.  I 
remember,  when  fifteen,  to  have  first  expressed  to  a  friend  the  wish  to  be 
a  girl.  In  answer  to  his  question,  I  could  not  give  the  reason  why.  At 
seventeen  I  got  into  fast  society ;  I  drank  beer,  smoked,  and  tried  to 
joke  with  waiter-girls.  The  latter  liked  my  society,  but  they  always 
treated  me  as  if  I  wore  petticoats.  I  could  not  take  dancing  lessons, 
they  repelled  me  so ;  but  if  I  could  have  gone  as  a  mask,  it  would  have 
been  different.  My  friends  loved  me  dearly  ;  I  hated  only  one,  who 
seduced  me  into  onanism.  Shame  on  those  days,  which  injured  me  for 
life!  I  practiced  it  quite  frequently,  but  in  it  seemed  to  myself  like  a 
double  man.  I  cannot  describe  the  feeling;  I  think  it  was  masculine, 
but  mixed  with  feminine  elements.  I  could  not  approach  girls ;  I  feared 
them,  but  they  were  not  strange  to  me.  They  impressed  me  as  being 
more  like  myself;  I  envied  them.  I  would  have  denied  myself  all 
pleasures  if,  after  my  classes,  at  home  I  could  have  been  a  girl  and  thus 
have  gone  out.  Crinoline  and  a  smoothly-fitting  glove  were  my  ideals. 
With  every  lady's  gown  I  saw  I  fancied  how  I  should  feel  in  it, — i.e.,  as  a 
lady.  I  had  no  inclination  toward  men.  But  I  remember  that  I  was 
somewhat  lovingly  attached  to  a  very  handsome  friend  with  a  girl's  face 
and  dark  hair,  though  I  think  I  had  no  other  wish  than  that  we  both 
might  be  girls. 

"  At  the  high-school  I  finally  once  had  coitus ;  hoc  modo  sensi, 
me  libentius  sub  puella  concubuisse  et  penem  meum  cum  cunno  mutatum 
maluisse.  To  my  astonishment,  too,  the  girl  had  to  treat  me  as  a  girl, 
and  did  it  willingly  ;  but  she  treated  me  as  if  I  were  she  (she  was  still 
quite  inexperienced,  and,  therefore,  did  not  laugh  at  me). 

"  When  a  student,  at  times  I  was  wild,  but  I  always  felt  that  I 
assumed  this  wildness  as  a  mask.  I  drank  and  duelled,  but  I  could  not 
take  lessons  in  dancing,  because  I  was  afraid  of  betraying  mj'self.  My 
friendships  were  close,  but  without  other  thoughts.  It  pleased  me  most 
to  have  a  friend  masked  as  a  lady,  or  to  study  the  ladies'  costumes  at  a 
ball.  I  understood  such  things  perfectly.  Gradually  I  began  to  feel 
like  a  girl. 


206  PSYCHOPATHIA   SEXUALIS. 

"  On  account  of  unhapp3r  circumstances,  I  twice  attempted  suicide. 
Without  any  cause  I  once  slept  fourteen  da3rs,  had  many  hallucinations 
(visual  and  auditory  at  the  same  time),  and  was  with  both  the  living  and 
the  dead.  The  latter  habit  of  thought  remains.  I  also  had  a  friend  (a 
lady)  who  knew  my  hobby  and  put  on  my  gloves  for  me ;  but  she  always 
looked  upon  me  as  a  girl.  Thus  I  understood  women  better  than  other 
men  did,  and  in  what  they  differed  from  men  ;  so  I  was  always  treated 
viore  feminarum, — as  if  they  had  found  in  me  a  female  friend.  On  the 
whole,  I  could  not  endure  obscenity,  and  indulged  in  it  myself  only  out 
of  braggadocio  when  it  was  necessary.  I  soon  overcame  my  aversion  to 
foul  odors  and  blood,  and  even  liked  them.  I  was  wanting  in  only  one 
respect :  I  could  not  understand  my  own  condition.  I  knew  that  I  had 
feminine  inclinations,  but  believed  that  I  was  a  man.  Yet  I  doubt 
whether,  with  the  exception  of  the  attempts  at  coitus,  which  never  gave 
me  pleasure  (which  I  ascribe  to  onanism),  I  ever  admh*ed  a  woman  with- 
out wishing  I  were  she;  or  without  asking  myself  whether  I  should  not 
like  to  be  the  woman,  or  be  in  her  attire.  Obstetrics  I  learned  with  dif- 
ficult3r  (I  was  ashamed  for  the  exposed  girls,  and  had  a  feeling  of  pity 
for  them) ;  and  even  now  I  have  to  overcome  a  feeling  of  fright  in 
obstetrical  cases ;  indeed,  it  has  happened  that  I  thought  I  felt  the  trac- 
tion myself.  After  filling  several  positions  successfully  as  a  ph}'sician, 
I  went  through  a  military  campaign  as  a  volunteer  surgeon.  Riding, 
which,  while  a  student,  was  painful  to  me,  because  in  it  the  genitals  had 
more  of  a  feminine  feeling,  was  difficult  for  me  (it  would  have  been 
easier  in  the  female  style). 

"  Still,  I  always  thought  I  was  a  man  with  obscure  masculine  feel- 
ing; and  whenever  I  associated  with  ladies,  I  was  still  soon  treated  as  an 
inexperienced  lady.  When  I  wore  a  uniform  for  the  first  time,  I  should 
have  much  preferred  to  have  slipped  into  a  lady's  costume,  with  a  veil ; 
I  was  disturbed  when  the  stateby  uniform  attracted  attention.  In  pri- 
vate practice  I  was  successful  in  the  three  principal  branches.  Then  I 
made  another  militaiy  campaign ;  and  during  this  I  came  to  understand 
my  nature ;  for  I  think  that,  since  the  first  ass,  no  beast  of  burden  has 
ever  had  to  endure  with  so  much  patience  as  I  have.  Decorations  were 
not  wanting,  but  I  was  indifferent  to  them. 

"  Thus  I  went  through  life,  such  as  it  was,  never  satisfied  with 
myself,  full  of  dissatisfaction  with  the  world,  and  vascillating  between 
sentimentality  and  a  wildness  that  was  for  the  most  part  affected. 

"  My  experience  as  a  candidate  for  matrimony  was  very  peculiar.  I 
should  have  preferred  not  to  marry,  but  family  circumstances  and  prac- 
tice forced  me  to  it.  I  married  an  energetic,  amiable  lady,  of  a  family  in 
which  female  government  was  rampant.  I  was  in  love  with  her  as  much 
as  one  of  us  can  be  in  love, — i.e.,  what  we  love  we  love  with  our  whole 
hearts,  and  live  in  it,  even  though  we  do  not  show  it  as  much  as  a  gen- 
uine man  does.    We  love  our  brides  with  all  the  love  of  a  woman,  almost 


ACQUIRED   HOMO-SEXUALITY.  207 

as  a  woman  might  love  her  bridegroom.  But  I  cannot  say  this  for 
myself;  for  I  still  believed  that  I  was  but  a  depressed  man,  who  would 
come  to  himself,  and  find  himself  out  by  marriagej\  But,  even  on  my 
marriage-night,  I  felt  that  I  was  only  a  woman  in  man's  form  ;  sub  femina 
locum  meum  esse  mihi  visum  est.  On  the  whole,  we  lived  contented  and 
happy,  and  for  two  years  were  childless.  After  a  difficult  pregnancy, 
during  which  I  was  in  mortal  fear  of  death,  the  first  boy  was  born  in  a 
difficult  labor, — a  boy  on  whom  a  melancholy  nature  still  hangs ;  who  is 
still  of  melancholy  disposition.  Then  came  a  second,  who  is  very  quiet; 
a  third,  full  of  peculiarities  ;  a  fourth,  a  fifth  ;  and  all  have  predisposition 
to  neurasthenia.  Since  I  always  felt  out  of  my  own  place,  I  went  much 
in  gay  society ;  but  I  always  worked  as  much  as  human  strength  would 
allow.  I  studied  and  operated ;  and  I  experimented  with  many  drugs 
and  methods  of  cure,  always  on  myself.  I  left  the  regulation  of  the 
house  to  my  wife,  as  she  understood  house-keeping  very  well.  My  mar- 
ital duties  I  performed  as  Well  as  I  could,  but  without  personal  satisfac- 
tion. Since  the  first  coitus,  the  masculine  position  in  it  has  been  repug- 
nant, and,  too,  difficult  for  me.  I  should  have  much  preferred  to  have 
the  other  role.  When  I  had  to  deliver  my  wife,  it  almost  broke  my 
heart ;  for  I  knew  how  to  appreciate  her  pain.  Thus  we  lived  long 
together,  until  severe  gout  drove  me  to  various  baths,  and  made  me 
neurasthenic.  At  the  same  time,  I  became  so  anaemic  that  every  few 
months  I  had  to  take  iron  for  some  time ;  otherwise  I  would  be  almost 
chlorotic  or  hysterical,  or  both.  Stenocardia  often  troubled  me ;  then 
came  unilateral  cramps  of  chin,  nose,  neck,  and  larynx ;  hemicrania  and 
cramps  of  the  diaphragm  and  chest-muscles.  For  about  three  years  I 
had  a  feeling  as  if  the  prostate  were  enlarged, — a  bearing-down  feeling, 
as  if  giving  birth  to  something;  and,  also,  pain  in  the  hips,  constant 
pain  in  the  back,  and  the  like.  Yet,  with  the  strength  of  despair,  I 
fought  against  these  complaints,  which  impressed  me  as  being  female  or 
effeminate,  until  three  years  ago,  when  a  severe  attack  of  arthritis 
completely  broke  me  down.  A 

"  But  before  this  terrible  attack  of  gout  occurred,  in  despair,  to 
lessen  the  pain  of  gout,  I  had  taken  hot  baths,  as  near  the  temperature 
of  the  body  as  possible.  On  one  of  these  occasions  it  happened  that  I 
suddenly  changed,  and  seemed  to  be  near  death.  I  sprang  with  all  my 
remaining  strength  out  of  the  bath  :  I  had  felt  exactly  like  a  woman 
with  libido.  Too,  at  the  time  when  the  extract  of  Indian  hemp  came 
into  vogue,  and  was  highly  prized,  in  a  state  of  fear  of  a  threatened 
attack  of  gout  (feeling  perfectly  indifferent  about  life),  I  took  three  or 
four  times  the  usual  dose  of  it,  and  almost  died  of  haschisch  poisoning. 
Convulsive  laughter,  a  feeling  of  unheard  of  strength  and  swiftness,  a 
peculiar  feeling  in  brain  and  eyes,  millions  of  sparks  streaming  from  the 
brain  through  the  skin, — all  these  feelings  occurred.  But  I  could  not 
force  myself  to  speak.     All  at  once  I  saw  myself  a  woman  from  my  toes 


208  PSYCHOPATHIA    SEXUALIS. 

to  my  breast;  I  felt,  as  before  while  in  the  bath,  that  the  genitals  had 
shrunken,  the  pelvis  broadened,  the  breasts  swollen  out;  a  feeling  of 
unspeakable  delight  came  over  me.  I  closed  my  eyes,  so  that  at  least 
I  did  not  see  the  face  changed.  My  physician  looked  as  if  he  had  a 
gigantic  potatoe  instead  of  a  head  ;  my  wife  had  the  full  moon  on  her 
nates.  And  j*et  I  was  strong  enough  to  briefly  record  my  will  in  my 
note-book  when  both  left  the  room  for  a  short  time. 

"  But  who  could  describe  my  fright,  when,  on  the  next  morning,  I 
awoke  and  found  myself  feeling  as  if  completely  changed  into  a  woman ; 
and  when,  on  standing  and  walking,  I  felt  vulva  and  mammae  !  When  at 
last  I  raised  myself  out  of  bed,  I  felt  that  a  complete  transformation 
had  taken  place  in  me.  During  my  sickness  a  visitor  said  :  '  He  is  too 
patient  for  a  man.'  And  the  visitor  gave  me  a  plant  in  bloom,  which 
seemed  strange,  but  pleased  me.  From  that  time  I  was  patient,  and 
would  do  nothing  in  a  hurry ;  but  I  became  tenacious,  like  a  cat, 
though,  at  the  same  time,  mild,  forgiving,  and  no  longer  bearing  enmity, 
— in  short,  I  had  a  woman's  disposition.  During  the  last  sickness  I  had 
many  visual  and  auditory  hallucinations, — spoke  with  the  dead,  etc. ;  saw 
and  heard  familiar  spirits;  felt  like  a  double  person  ;  but,  while  lying  ill, 
I  did  not  notice  that  the  man  in  me  had  been  extinguished.  The  change 
in  my  disposition  was  a  piece  of  good  fortune  which  came  over  me  like 
lightning,  and  which,  had  it  come  with  me  feeling  as  I  formerly  did, 
would  have  killed  me ;  but  now  I  gave  myself  up  to  it,  and  no  longer 
recognized  myself.  Owing  to  the  fact  that  I  still  often  confounded  neu- 
rasthenic symptoms  with  the  gout,  I  took  man}'  baths,  until  an  itching 
of  the  skin  with  the  feeling  of  scabies,  instead  of  being  diminished,  was 
so  increased  that  I  gave  up  all  external  treatment  (I  was  made  more  and 
more  anaemic  by  the  baths),  and  hardened  myself  as  best  I  could.  But 
the  imperative  female  feeling  remained,  and  became  so  strong  that  I  wear 
only  the  mask  of  a  man,  and  in  everything  else  feel  like  a  woman  ;  and 
gradually  I  have  lost  memo^  of  the  former  individuality.  What  was 
left  of  me  from  the  gout,  the  influenza  ruined  entirely. 

"  Present  Condition:  I  am  tall,  slightly  bald,  and  the  beard  is  grow- 
ing gray.  I  begin  to  stoop.  Since  having  the  influenza,  I  have  lost 
about  a  quarter  of  my  strength.  Owing  to  a  valvular  lesion,  my  face 
looks  somewhat  red  ;  full  beard;  chronic  conjunctivitis  ;  more  muscular 
than  fat.  The  left  foot  seems  to  be*  developing  varicose  veins,  and  it 
often  goes  to  sleep;  but  it  is  not  really  thickened,  though  it  seems  to  be. 

"  The  mammary  region,  though  small,  swells  out  perceptibly.  The 
abdomen  is  feminine  in  form  ;  the  feet  are  placed  like  a  woman's,  and  the 
calves,  etc.,  are  feminine ;  and  it  is  the  same  with  arms  and  hands.  I 
can  wear  ladies'  hose,  and  gloves,  1^  to  7f  in  size.  I  also  wear  a  corset 
without  annoyance.  My  weight  varies  between  168  and  184  pounds. 
Urine  without  albumen  or  sugar,  but  it  contains  an  excess  of  uric  acid. 
But  if  there  is  not  too  much  uric  acid  in  it,  it  is  clear,  and  almost  as 


ACQUIRED    HOMOSEXUALITY.  209 

clear  as  water  after  any  excitement.  Bowels  usually  regular ;  but  should 
they  not  be,  then  come  all  the  S3^mptoms  of  female  obstipation.  Sleep 
is  poor, — for  weeks  at  a  time  only  two  or  three  hours  long.  Appetite 
quite  good  ;  but,  on  the  whole,  my  stomach  will  not  bear  more  than  that 
of  a  strong  woman,  anil  reacts  to  irritating  food  with  cutaneous  eruption 
and  burning  in  the  urethra.  The  skin  is  white,  and,  for  the  most  part, 
feels  quite  smooth  ;  there  has  been  unbearable  cutaneous  itching  for  the 
last  two  years  ;  but  during  the  last  few  weeks  it  has  diminished,  and  is 
now  present  only  in  the  popliteal  spaces  and  on  the  scrotum. 

"  Tendency  to  perspire.  Perspiration  was  previously  as  good  as 
wanting,  but  now  there  are  all  the  odious  peculiarities  of  the  female  per- 
spiration, particularly  about  the  lower  part  of  the  hody ;  so  that  I  have 
to  keep  myself  cleaner  than  a  woman.  (I  perfume  my  handkerchief,  and 
use  perfumed  soap  and  eau-de-Cologne.) 

"  General  Feeling :  I  feel  like  a  woman  in  a  man's  form ;  and  even 
though  I  often  am  sensible  of  the  man's  form,  3ret  it  is  always  in  a  fem- 
inine sense.  Thus,  for  example,  I  feel  the  penis  as  clitoris  ;  the  urethra 
as  urethra  and  vaginal  orifice,  which  always  feels  a  little  wet,  even  when 
it  is  actually  dry;  the  scrotum  as  labia  majora;  in  short,  I  always  feel 
the  vulva.  And  all  that  that  means  one  alone  can  know  who  feels  or  has 
felt  so.  But  the  skin  all  over  my  body  feels  feminine ;  it  receives  all 
impressions,  whether  of  touch,  of  warmth,  or  whether  unfriendly,  as 
feminine,  and  I  have  the  sensations  of  a  woman.  I  cannot  go  with  bare 
hands,  as  both  heat  and  cold  trouble  me.  When  the  time  is  past 
when  we  men  are  permitted  to  carry  sun-umbrellas,  I  have  to  endure 
great  sensitiveness  of  the  skin  of  my  face,  until  sun-umbrellas  can  again 
be  used.  On  awaking  in  the  morning,  I  am  confused  for  a  few  moments, 
as  if  I  were  seeking  for  myself;  then  the  imperative  feeling  of  being  a 
woman  awakens.  I  feel  the  sense  of  the  vulva  (that  one  is  there),  and 
always  greet  the  day  with  a  soft  or  loud  sigh  ;  for  I  have  fear  again  of 
the  play  that  must  be  carried  on  throughout  the  day.  I  had  to  learn 
everything  anew;  the  knife — apparatus,  everything — has  felt  different 
for  the  last  three  years  ;  and  with  the  change  of  muscular  sense  I  had  to 
learn  everything  over  again.  I  have  been  successful,  and  only  the  use 
of  the  saw  and  bone-chisel  are  difficult;  it  is  almost  as  if  my  strength 
were  not  quite  sufficient.  On  the  other  hand,  I  have  a  keener  sense  of 
touch  in  working  with  the  curette  in  the  soft  parts.  It  is  unpleasant 
that,  in  examining  ladies,  I  often  feel  their  sensations ;  but  this,  indeed, 
does  not  repell  them.  The  most  unpleasant  thing  I  experience  is  foetal 
movement.  For  a  long  time — several  months — I  was  troubled  by  read- 
ing the  thoughts  of  both  sexes,  and  I  still  have  to  fight  against  it.  I 
can  endure  it  better  with  women ;  with  men  it  is  repugnant.  Three 
years  ago  I  had  not  yet  consciously  seen  the  world  with  a  woman's  eyes  ; 
this  change  in  the  relation  of  the  e}*es  to  the  brain  came  almost  sud- 
denly, with  violent  headache.     I  was  with  a  lady  whose  sexual  feeling 


210  PSTCHOPATHIA   SEXUALIS. 

was  reversed,  when  suddenly  I  saw  her  changed  in  the  sense  I  now  feel 
myself, — viz.,  she  as  man, — and  I  felt  myself  a  woman  in  contrast  with 
her ;  so  that  I  left  her  with  ill-concealed  vexation.  At  that  time  she  had 
not  yet  come  to  understand  her  own  condition  perfectly. 

"  Since  then,  all  my  sensory  impressions  are  as  if  they  were 
feminine  in  form  and  relation.  The  cerebral  system  almost  immedi- 
ately adjusted  itself  to  the  vegetative;  so  that  all  my  ailments  were 
manifested  in  a  feminine  way.  The  sensitiveness  of  all  nerves,  particu- 
larly that  of  the  auditory  and  olfactory  and  trigeminal,  increased  to  a 
condition  of  nervousness.  If  only  a  window  slammed,  I  was  frightened 
inwardly  ;  for  a  man  dare  not  tremble  at  such  things.  If  food  is  not 
absolutely  fresh,  I  perceive  a  cadaverous  odor.  I  could  never  depend 
on  the  trigeminus;  for  the  pain  would  jump  whimsically  from  one 
branch  of  it  to  another ;  from  a  tooth  to  an  eye.  But,  since  my  trans- 
formation, I  bear  toothache  and  migraine  more  easily,  and  have  less  feel- 
ing of  fear  with  stenocardia.  It  seems  to  me  a  strange  fact  that  I  feel 
myself  to  be  a  fearful,  weak  being,  and  yet,  when  danger  threatens,  I  am 
much  rather  cool  and  collected  ;  and  this  is  true  in  dangerous  operations. 
The  stomach  rebels  against  the  slightest  indiscretion  (in  female  diet) 
that  is  committed  without  thought  of  the  female  nature,  either  by  ructus 
or  other  symptoms ;  but  particularly  against  abuse  of  alcoholics.  The 
indisposition  after  intoxication  that  a  man  who  feels  like  a  woman  expe- 
riences is  much  worse  than  any  a  student  could  get  up.  It  seems  to  me 
almost  as  if  one  feeling  like  a  woman  were  entirety  controlled  by  the 
vegetative  sj^stem. 

"  Small  as  my  nipples  are,  they  demand  room,  and  I  feel  them  as 
mammae ;  just  as  during  the  beginning  of  puberty,  the  nipples  swelled  and 
pained.  On  this  account,  the  white  shirt,  the  waistcoat,  and  the  coat 
trouble  me.  I  feel  as  though  the  pelvis  were  female ;  and  it  is  the  same  with 
the  anus  and  nates.  At  first  the  sense  of  a  female  abdomen  was  trouble- 
some to  me ;  for  it  cannot  bear  trousers,  and  it  always  possesses  or  in- 
duces the  feminine  feeling.  I  also  have  the  imperative  feeling  of  a  waist. 
It  is  as  if  I  were  robbed  of  my  own  skin,  and  put  in  a  woman's  skin  that 
fitted  me  perfectly,  but  which  felt  everything  as  if  it  covered  a  woman ;  and 
whose  sensations  passed  through  the  man's  body,  and  exterminated  the 
masculine  element.  The  testes,  even  though  not  atrophied  or  degenerated, 
are  still  no  longer  testes,  and  often  cause  me  pain,  with  the  feeling  that  they 
belong  in  the  abdomen,  and  should  be  fastened  there  ;  and  their  mobility 
often  bothers  me. 

"  Every  four  weeks,  at  the  time  of  the  full  moon,  I  have  the  moli- 
men  of  a  woman  for  five  days,  physically  and  mentally,  only  I  do  not 
bleed  ;  but  I  have  the  feeling  of  a  loss  of  fluid ;  a  feeling  that  the  genitals 
and  abdomen  are  (internally)  swollen.  A  very  pleasant  period  comes 
when,  afterward  and  later  in  the  interval  for  a  day  or  two,  the  physiologi- 
cal desire   for  procreation  comes,  which  with  all   power  permeates  the 


ACQUIRED   HOMOSEXUALITY.  211 

woman.  My  whole  body  is  then  filled  with  this  sensation,  as  an  immersed 
piece  of  sugar  is  filled  with  water,  or  as  full  as  a  soaked  sponge.  It  is 
like  this  :  first,  a  woman  longing  for  love,  and  then,  for  a  man ;  and,  in  fact, 
the  desire,  as  it  seems  to  me,  is  more  a  longing  to  be  possessed  than  a 
wish  for  coitus.  The  intense  natural  instinct  or  the  feminine  concupis- 
cence overcomes  the  feeling  of  modesty,  so  that  indirectly  coitus  is 
desired.  I  have  never  felt  coitus  in  a  masculine  way  more  than  three 
times  in  my  life ;  and  even  if  it  were  so  in  general,  I  was  always  indifferent 
about  it.  But,  during  the  last  three  years,  I  have  experienced  it  passively, 
like  a  woman ;  in  fact,  oftentimes  with  the  feeling  of  feminine  ejaculation ; 
and  I  always  feel  that  I  am  impregnated.  I  am  always  fatigued  as  a 
woman  is  after  it,  and  often  feel  ill,  as  a  man  never  does.  Sometimes  it 
caused  me  so  great  pleasure  that  there  is  nothing  with  which  I  can  com- 
pare it ;  it  is  the  most  blissful  and  powerful  feeling  in  the  world ;  at  that 
moment  the  woman  is  simply  a  vulva  that  has  devoured  the  whole 
person. 

"  During  the  last  three  years  I  have  never  lost  for  an  instant  the 
feeling  of  being  a  woman,  and  now,  owing  to  habit,  this  is  no  longer  an- 
noying to  me,  though  during  this  period  I  have  felt  debased ;  for  a  man 
could  endure  to  feel  like  a  woman  without  a  desire  for  enjoyment ;  but 
when  desires  come !  The  happiness  ceases ;  then  come  the  burning,  the 
heat,  the  feeling  of  turgor  of  the  genitals  (when  the  penis  is  not  in  a  state 
of  erection  the  genitals  do  not  play  any  part).  In  case  of  intense  desire, 
the  feeling  of  sucking  in  the  vagina  and  vulva  is  really  terrible — a  hellish 
pain  of  lust  hardly  to  be  endured.  If  I  then  have  opportunity  to  per- 
form coitus,  it  is  better ;  but,  owing  to  defective  sense  of  being  possessed 
by  the  other,  it  does  not  afford  complete  satisfaction ;  the  feeling  of 
sterility  comes  with  its  weight  of  shame,  added  to  the  feeling  of  passive 
copulation  and  injured  modesty.  I  seem  almost  like  a  prostitute.  Reason 
does  not  give  any  help ;  the  imperative  feeling  of  femininity  dominates 
and  rules  everything.  The  difficulty  in  carrying  on  one's  occupation, 
under  such  circumstances,  is  easily  appreciated  ;  but  it  is  possible  to  force 
one's  self  to  it.  Of  course,  it  is  almost  impossible  to  sit,  wTalk,  or  lie  down  ; 
at  least,  any  one  of  these  cannot  be  endured  long ;  and  with  the  constant 
touch  of  the  trousers,  etc.,  it  is  unendurable. 

"  Marriage  then,  except  during  coitus,  where  the  man  has  to  feel 
himself  a  woman,  is  like  two  women  living  together,  one  of  whom  re- 
gards herself  as  in  the  mask  of  a  man.  If  the  periodical  molimen  fail  to 
occur,  then  come  the  feelings  of  pregnancy  or  of  sexual  satiety,  which  a 
man  never  experiences,  but  which  take  possession  of  the  whole  being, 
just  as  the  feeling  of  femininity  does,  and  are  repugnant  in  themselves  ; 
and,  therefore,  I  gladly  welcome  the  regular  molimen  again.  When  erotic 
dreams  or  ideas  occur,  I  see  myself  in  the  form  I  have  as  a  woman,  and 
see  erected  organs  presenting.  Since  the  anus  feels  feminine,  it  would  not 
be  hard  to  become  a  passive  pederast ;  only  positive  religious  command 


212  PSYCHOPATHIA    SEXUALIS. 

prevents  it,  as  all  other  deterrent  ideas  would  be  overcome.  Since  such 
conditions  are  repugnant,  as  they  would  be  to  any  one,  I  have  a  desire  to 
be  sexless,  or  to  make  myself  sexless.  If  I  had  been  single,  I  should  long 
ago  have  taken  leave  of  testes,  scrotum,  and  penis* 

"  Of  what  use  is  female  pleasure,  when  one  does  not  conceive  t 
What  good  comes  from  excitation  of  female  love,  when  one  has  only 
a  wife  for  gratification,  even  though  copulation  is  felt  as  though  it  were 
with  a  man  ?  What  a  terrible  feeling  of  shame  is  caused  by  the  feminine 
perspiration !  How  the  feeling  for  dress  and  ornament  lowers  a  man ! 
Even  in  his  changed  form,  even  when  he  can  no  longer  recall  the  mascu- 
line sexual  feeling,  he  would  not  wish  to  be  forced  to  feel  like  a  woman. 
He  still  knows  very  well  that,  before,  he  did  not  constantly  feel  sexually; 
that  he  was  merely  a  human  being  uninfluenced  by  sex.  Now,  sud- 
denly, he  has  to  regard  his  former  individuality  as  a  mask,  and  constantly 
feel  like  a  woman,  only  having  a  change  when,  every  four  weeks,  he  has 
his  periodical  sickness,  and  in  the  intervals  his  insatiable  female  desire. 
If  he  could  but  awake  without  immediately  being  forced  to  feel  like  a 
woman!  At  last  he  longs  for  a  moment  in  which  he  might  raise  his 
mask ;  but  that  moment  does  not  come.  He  can  only  find  amelioration 
of  his  misery  when  he  can  put  on  some  bit  of  female  attire  or  finery,  an 
under-garment,  etc. ;  for  he  dare  not  go  about  as  a  woman.  To  be  com- 
pelled to  fulfill  all  the  duties  of  a  calling  with  the  feeling  of  being  a 
woman  costumed  as  a  man,  and  to  see  no  end  of  it,  is  no  trifle.  Religion 
alone  saves  from  a  great  lapse ;  but  it  does  not  prevent  the  pain  when 
temptation  affects  the  man  who  feels  as  a  woman  ;  and  so  it  must  be  felt 
and  endured !  When  a  respectable  man  who  enjoys  an  unusual  degree  of 
public  confidence,  and  possesses  authority,  must  go  about  with  his  vulva — 
imaginary  though  it  be;  when  one, leaving  his  arduous  daily  task,  is  com- 
pelled to  examine  the  toilette  of  the  first  lady  he  meets,  and  criticise  her 
with  feminine  eyes,  and  read  her  thoughts  in  her  face;  when  a  journal  of 
fashions  possesses  an  interest  equal  to  that  of  a  scientific  work  (I  felt 
this  as  a  child) ;  when  one  must  conceal  his  condition  from  his  wife, 
whose  thoughts,  the  moment  he  feels  like  a  woman,  he  can  read  in  her 
face,  while  it  becomes  perfectly  clear  to  her  that  he  has  changed  in  body 
and  soul, — what  must  all  this  be?  The  misery  caused  by  the  feminine 
gentleness  that  must  be  overcome !  Oftentimes,  of  course,  when  I  am 
away  alone,  it  is  possible  to  live  for  a  time  more  like  a  woman ;  for  ex- 
ample, to  wear  female  attire,  especially  at  night,  to  keep  gloves  on,  or  to 
wear  a  veil  or  a  mask  in  my  room,  so  that  thus  there  is  rest  from  exces- 
sive libido.  But  when  the  feminine  feeling  has  once  gained  an  entrance, 
it  imperatively  demands  recognition.  It  is  often  satisfied  with  a  moder- 
ate concession,  such  as  the  wearing  of  a  bracelet  above  the  cuff;  but  it 
imperatively  demands  some  concession.  My  only  happiness  is  to  see 
myself  dressed  as  a  woman  without  a  feeling  of  shame ;  indeed,  when  my 
face  is  veiled  or  masked,  I  prefer  it  so,  and  thus  think  of  myself.     Like 


ACQUIRED   HOMO-SEXUALITY.  213 

every  one  of  Fashion's  fools,  I  have  a  taste  for  the  prevailing  mode ; 
so  greatly  am  I  transformed.  To  become  accustomed  to  the  thought  of 
feeling  only  like  a  woman,  and  only  to  remember  the  previous  manner  of 
thought  to  a  certain  extent  in  contrast  with  it ;  and,  at  the  same  time,  to 
express  one's  self  as  a  man, — it  requires  a  long  time  and  an  infinite 
amount  of  persistence. 

"  Nevertheless,  in  spite  of  everything,  it  will  happen  that  I  betray 
myself  by  some  expression  of  feminine  feeling,  either  in  sexualibus,  when 
I  say  that  I  feel  so  and  so,  expressing  what  a  man  without  the  female 
feeling  cannot  know;  or  when  I  accidentally  betray  that  female  attire 
is  my  talent.  Before  women,  of  course,  this  does  not  amount  to  any- 
thing ;  for  a  woman  is  greatly  flattered  when  a  man  understands  some- 
thing of  her  matters ;  but  this  must  not  be  displayed  to  my  own  wife. 
How  frightened  I  once  was  when  my  wife  said  to  a  friend  that  I  had 
great  taste  in  ladies'  dress!  How  a  haughty,  stylish  lady  was  astonished 
when,  as  she  was  about  to  make  a  great  error  in  the  education  of  her  little 
daughter,  I  described  to  her  in  writing  and  verbally  all  the  feminine 
feelings !  To  be  sure,  I  lied  to  her,  saying  that  my  knowledge  had  been 
gleaned  from  letters.  But  her  confidence  in  me  is  as  great  as  ever ;  and 
the  child,  who  was  on  the  road  to  insanity,  is  rational  and  happy.  She 
had  confessed  all  the  feminine  inclinations  as  sins ;  now  she  knows  what, 
as  a  girl,  she  must  bear  and  control  by  will  and  religion ;  and  she  feels 
that  she  is  human.  Both  ladies  would  laugh  heartily,  if  they  knew  that 
I  had  only  drawn  on  my  own  sad  experience.  I  must  also  add  that  I 
now  have  a  finer  sense  of  temperature  and,  besides,  a  sense  of  the 
elasticity  of  the  skin  and  tension  of  the  intestines,  etc.,  in  patients,  that 
was  unknown  to  me  before ;  that  in  operations  and  autopsies,  poisonous 
fluids  more  readily  penetrate  my  (uninjured)  skin.  Every  autopsy  causes 
me  pain  ;  examination  of  a  prostitute,  or  a  woman  having  a  discharge,  a 
cancerous  odor,  or  the  like,  is  actually  repugnant  to  me.  In  all  respects 
I  am  now  under  the  influence  of  antipathy  and  sympathy,  from  the  sense 
of  color  to  my  judgment  of  a  person.  Women  usually  see  in  each  other 
the  periodical  sexual  disposition;  and,  therefore,  a  lady  wears  a  veil,  if 
she  is  not  always  accustomed  to  wear  one,  and  usually  she  perfumes  her- 
self, even  though  it  be  only  with  handkerchief  or  gloves ;  for  her  olfactory 
sense  in  relation  to  her  own  sex  is  intense.  Odors  have  an  incredible 
effect  on  the  female  organism  ;  thus,  for  example,  the  odors  of  violets  and 
roses  quiet  me,  while  others  disgust  me ;  and  with  ihlang-ihlang  I  cannot 
contain  myself  for  sexual  excitement.  Contact  with  a  woman  seems 
homogeneous  to  me ;  coitus  with  my  wife  seems  possible  to  me  because 
she  is  somewhat  masculine,  and  has  a  firm  skin ;  and  yet  it  is  more  an 
amor  lesbicus. 

"  Besides,  I  always  feel  passive.  Often  at  night,  when  I  cannot 
sleep  for  excitement,  it  is  finally  accomplished,  si  femora  mea  distensa 
habeo,  sicut  mulier  cum  viro  concumbens,  or  if  I  lie  on  my  side ;  but  an 


214  PSYCHOPATHIA   SEXUALlS. 

arm  or  the  bed-clothing  must  not  touch  the  mammae,  or  there  is  no  sleep; 
and  there  must  be  no  pressure  on  the  abdomen.  I  sleep  best  in  a  chemise 
and  night-robe,  and  with  gloves  on  ;  for  my  hands  easily  get  cold.  I  am  also 
comfortable  in  female  drawers  and  petticoats,  because  they  do  not  touch 
the  genitals.  I  liked  female  dresses  best  when  crinoline  was  worn.  Female 
dresses  do  not  annoy  the  feminine-feeling  man ;  for  he,  like  every  woman, 
feels  them  as  belonging  to  his  person,  and  not  as  something  foreign. 

"  My  dearest  associate  is  a  lady  suffering  with  neurasthenia,  who, 
since  her  last  confinement,  feels  like  a  man,  but  who,  since  I  explained 
these  feelings  to  her,  coitu  abstinet  as  much  as  possible,  a  thing  I,  as  a 
husband,  dare  not  do.  She,  by  her  example,  helps  me  to  endure  my  con- 
dition. She  has  a  more  perfect  memory  of  the  female  feelings,  and  has 
often  given  me  good  advice.  Were  she  a  man  and  I  a  young  girl,  I 
should  seek  to  win  her ;  for  her  I  should  be  glad  to  endure  the  fate  of  a 
woman.  But  her  present  appearance  is  quite  different  from  what  it 
formerly  was.  She  is  a  very  elegantly  dressed  gentleman,  notwithstand- 
ing bosom  and  hair ;  she  also  speaks  quickly  and  concisely,  and  no  longer 
takes  pleasure  in  the  things  that  please  me.  She  has  a  kind  of  melan- 
choly dissatisfaction  with  the  world,  but  she  bears  her  fate  worthily  and 
with  resignation,  finding  her  comfort  only  in  religion  and  the  fulfillment 
of  duty.  At  the  time  of  the  menses,  she  almost  dies.  She  no  longer 
likes  female  society  and  conversation,  and  has  no  liking  for  delicacies. 

"  A  youthful  friend  felt  like  a  girl  from  the  very  first,  but  he  had 
inclinations  toward  the  male  sex.  His  sister  had  the  opposite  condi- 
tion ;  and  when  the  uterus  demanded  its  right,  and  she  saw  herself  as  a 
loving  woman,  in  spite  of  her  masculinity,  she  cut  the  matter  short,  and 
committed  suicide  by  drowning. 

"  Since  complete  effemination,  the  principal  changes  I  have  observed 
in  myself  are  : — 

"  1.  The  constant  feeling  of  being  a  woman  from  top  to  toe. 

"  2.  The  constant  feeling  of  having  female  genitals. 

"  3.  The  periodicity  of  the  monthly  molimen. 

"  4.  The  regular  occurrence  of  female  desire,  though  not  directed  to 
any  particular  man. 

"  5.  The  passive  female  feeling  in  coitus. 

"  6.  After  that,  the  feeling  of  impregnation. 

"  7.  The  female  feeling  in  thought  of  coitus. 

"  8.  At  the  sight  of  women,  the  feeling  of  being  of  their  kind,  and 
the  feminine  interest  in  them. 

"  9.  At  the  sight  of  men,  the  feminine  interest  in  them. 

"  10.  At  the  sight  of  children,  the  same  feeling. 

"11.  The  changed  disposition  and  much  greater  patience. 

"  12.  The  final  resignation  to  my  fate,  for  which  I  have  nothing  to 
thank  but  positive  religion ;  without  it  1  should  have  long  ago  committed 
suicide. 


ACQUIRED   HOMO-SEXUALITY.  215 

"  To  be  a  man  and  to  be  compelled  to  feel  that  chaque  femme  est 
futude  ou  elle  ddsire  d'etre,  is  hardly  to  be  endured." 

The  foregoing  autobiography,  scientifically  so  important, 
was  accompanied  by  the  following  no  less  interesting  letter : — 

"  Sir  :  I  must  next  beg  your  indulgence  for  troubling  you  with  my 
communication.  I  lost  all  control,  and  thought  of  myself  only  as  a 
monster  before  which  I  myself  shuddered.  Then  your  work  gave  me 
courage  again  ;  and  I  determined  to  go  to  the  bottom  of  the  matter,  and 
examine  my  past  life,  let  the  result  be  what  it  might.  It  seemed  a  duty  of 
gratitude  to  you  to  tell  you  the  result  of  my  recollection  and  observation, 
since  I  had  not  seen  any  description  by  you  of  an  analogous  case ;  and, 
finally,  I  also  thought  it  might  perhaps  interest  you  to  learn,  from  the  pen 
of  a  physician,  how  such  a  worthless  human,  or  masculine,  being  thinks 
and  feels  under  the  weight  of  the  imperative  idea  of  being  a  woman. 

"  It  is  not  perfect ;  but  I  no  longer  have  the  strength  to  reflect  more 
upon  it,  and  have  no  desire  to  go  into  the  matter  more  deeply.  Much  is 
repeated ;  but  I  beg  you  to  remember  that  any  mask  may  be  allowed  to 
fall  off,  particularly  when  it  is  not  voluntarily  worn,  but  enforced. 

"  After  reading  your  work,  I  hope  that,  if  I  fulfill  my  duties  as 
physician,  citizen,  father,  and  husband,  I  may  still  count  myself  among 
human  beings  who  do  not  deserve  merely  to  be  despised. 

"  Finally,  I  wished  to  lay  the  result  of  my  recollection  and  reflec- 
tion before  you,  in  order  to  show  that  one  thinking  and  feeling  like  a 
woman  can  still  be  a  physician.  I  consider  it  a  great  injustice  to  debar 
woman  from  Medicine.  A  woman,  through  her  feeling,  gets  on  the  track 
of  many  ailments  which,  in  spite  of  all  skill  in  diagnosis,  remain  obscure 
to  a  man ;  at  least,  in  the  diseases  of  women  and  children.  If  I  could  have 
my  way,  I  should  have  every  physician  live  the  life  of  a  woman  for  three 
months ;  then  he  would  have  a  better  understanding  and  more  considera- 
tion in  matters  affecting  the  half  of  humanity  from  which  he  comes ;  then 
he  would  learn  to  value  the  greatness  of  women,  and  appreciate  the 
difficulty  of  their  lot." 

Remarks:  The  badly-tainted  patient  is  originally  psycho-sexually 
abnormal,  in  that,  in  character  and  in  the  sexual  act,  he  feels  as  a  female. 
This  abnormal  feeling  remained  purely  a  psychical  anomaly  until  three 
years  ago,  when,  owing  to  severe  neurasthenia,  it  received  overmastering 
support  in  imperative  bodily  sensations  of  a  transmutatio  sexus,  which  now 
dominate  consciousness.  Then,  to  the  patient's  horror,  he  felt  bodily 
like  a  woman ;  and,  under  the  impulse  of  his  imperative  feminine  sensa- 
tions, he  experienced  a  complete  transformation  of  his  former  masculine 
feeling,  thought,  and  will ;  in  fact,  of  his  whole  vita  sexualis,  in  the  sense 
of  eviration.  At  the  same  time,  his  ego  is  able  to  control  these  abnormal 
psycho-physical    manifestations,   and    prevent    descent  to   paranoia, — a 


216  PSYOHOPATHIA   SEXUALIS. 

remarkable  example  of  imperative  feelings  and  ideas  on  the  basis  of 
neurotic  taint,  which  is  of  great  value  for  a  comprehension  of  the  way  in 
which  the  psycho-sexual  transformation  may  be  accomplished. 

IV.  Degree:  Metamorphosis  Sexualis  Paranoica. — A  final 
possible  stage  in  this  disease-process  is  the  delusion  of  a  trans- 
formation of  sex.  It  arises  on  the  basis  of  sexual  neurasthenia 
that  has  developed  into  neurasthenia  universalis,  resulting  in  a 
mental  disease, — paranoia. 

The  following  cases  show  the  development  of  the  inter- 
esting neuro-psychological  process  to  its  height : — 

Case  100.  K.,  aged  36,  single,  servant,  received  at  the  clinic  on 
February  26,  1889,  is  a  typical  case  of  paranoia  persecutoria,  resulting 
from  neurasthenia  sexualis,  with  olfactory  hallucinations,  sensations, 
etc.  He  comes  of  a  predisposed  family.  Several  brothers  and  sisters 
were  psychopathic.  Patient  has  an  hydrocephalic  skull,  depressed  in  the 
region  of  the  right  fontanelle ;  eyes  neuropathic.  He  has  always  been 
very  sensual ;  began  to  masturbate  at  nineteen ;  had  coitus  at  twenty- 
three  ;  begat  three  illegitimate  children.  He  gave  up  further  sexual 
intercourse,  on  account  of  fear  of  begetting  more  children,  and  of  being 
unable  to  provide  for  them.  Abstinence  proved  very  painful  to  him.  He 
also  gave  up  masturbation,  and  was  then  troubled  with  pollutions.  A 
year  and  a  half  ago  he  became  sexually  neurasthenic,  had  diurnal  pollu- 
tions, became  thereafter  ill  and  miserable,  and,  after  a  time,  generally  neu- 
rasthenic, finally  developing  paranoia.  A  year  ago  he  began  to  have 
paresthetic  sensations, — as  if  there  were  a  great  coil  in  the  place  of  his 
genitals ;  and  then  he  felt  that  his  scrotum  and  penis  were  gone,  and  that 
his  genitals  were  changed  into  those  of  a  female.  He  felt  the  growth  of 
his  breasts ;  that  his  hair  was  that  of  a  woman ;  and  that  feminine  gar- 
ments were  on  his  body.  He  thought  himself  a  woman.  The  people  in 
the  street  gave  utterance  to  corresponding  remarks :  "  Look  at  the 
woman !  The  old  blowhard !  "  In  a  half  dreamy  state,  he  had  the  feeling 
as  if  he  played  the  part  of  a  woman  in  coitus  with  a  man.  During  it 
he  had  the  most  lively  feelings  of  pleasure.  During  his  stay  at  the 
clinic,  a  remission  of  the  paranoia  occurred,  and,  at  the  same  time,  a 
marked  improvement  of  the  neurasthenia.  Then  the  feelings  and  ideas 
due  to  a  developing  metamorphosis  sexualis  disappeared. 

A  more  advanced  case  of  eviration,  on  the  way  to  a  trans- 
formatio  sexus  paranoica,  is  the  following : — 

Case  101.  Franz  St.,  aged  33;  school-teacher;  single;  probably  of 
.  tainted  family  ;  always  neuropathic ;  emotional,  timid,  intolerant  of  alco- 


ACQUIRED   HOMO-SEXUALITY.  217 

hoi ;  began  to  masturbate  at  eighteen.  At  thirty  there  were  manifesta- 
tions of  neurasthenia  sexualis  (pollutions  with  consequent  fatigue,  which 
at  last  began  to  occur  during  the  day ;  pain  in  the  region  of  the  sacral 
plexus,  etc.).  Gradually,  spinal  irritation,  pressure  in  the  head,  and  cere- 
bral neurasthenia  were  added.  Since  the  beginning  of  1885  the  patient 
had  given  up  coitus,  in  which  he  no  longer  experienced  pleasurable  feel- 
ing.    He  masturbated  frequently. 

In  1888  he  began  to  have  delusions  of  suspicion.  He  noticed  that 
he  was  avoided,  and  that  he  had  unpleasant  odors  about  him  (olfactory 
hallucinations).  In  this  way  he  explained  the  altered  attitude  of  people, 
and  their  sneezing,  coughing,  etc.  He  smelled  corpses  and  foul  urine. 
He  recognized  the  cause  of  his  bad  smells  in  inward  pollutions.  He 
recognized  these  in  a  feeling  he  had  as  if  a  fluid  flowed  up  from  the  sym- 
physis toward  the  breast.     Patient  soon  left  the  clinic. 

In  1889  he  was  again  received  in  an  advanced  stage  of  paranoia 
masturbatoria  persecutoria  (delusions  of  physical  persecution). 

In  the  beginning  of  May,  1889,  the  patient  attracted  notice,  in  that 
he  was  cross  when  he  was  addressed  as  "  mister."  B  He  protested  against 
it,  because  he  was  a  woman.  Voices  told  him  this.  He  noticed  that  his 
breasts  were  growing.  Some  weeks  before,  others  had  touched  him  in  a 
sensual  manner.  He  heard  it  said  that  he  was  a  whore.  Of  late,  dreams 
of  pregnancy.  He  dreamed  that,  as  a  woman,  he  indulged  in  coitus.  He 
felt  the  immissio  penis,  and,  during  the  hallucinatory  act,  also  a  feeling 
of  ejaculation. 

Head  straight ;  facial  form  long  and  narrow ;  parietal  eminences 
prominent;  genitals  normally  developed. 

The  following  case,  observed  in  the  asylum  at  Illenau,  is  a 
pertinent  example  of  lasting  delusional  alteration  of  sexual 
consciousness : — 

Case  102.  Metamorphosis  Sexualis  Paranoica. — N.,  aged  23,  single, 
pianist,  was  received  in  the  asylum  at  Illenau  in  the  last  part  of  October, 
1865.  He  came  of  a  family  in  which  there  was  said  to  be  no  hereditary 
taint ;  but  it  was  tuberculous  (father  and  brother  died  of  pulmonary 
tuberculosis).  Patient,  as  a  child,  was  weakly  and  dull,  though  especially 
talented  in  music.  He  was  always  of  abnormal  character ;  silent,  retir- 
ing, unsocial,  and  sullen.  He  practiced  masturbation  after  fifteen.  After 
a  few  years  neurasthenic  symptoms  (palpitation  of  the  heart,  lassitude, 
occasional  pressure  in  the  head,  etc.),  and  also  hypochondriacal  symp- 
toms, were  manifested.  During  the  last  year  he  had  worked  with  great 
difficulty.  For  about  six  months  neurasthenia  had  increased.  He  com- 
plained of  palpitation  of  the  heart,  pressure  in  the  head,  and  sleep- 
lessness; was  very  irritable,  and  seemed  to  be  sexually  excited.  He 
declared  that  he  must  marry  for  his  health.     He  fell  in  love  with  an 


21 8  PSYCHOPATHIA   SEXUALIS. 

artist,  but  almost  at  the  same  time  (September,  1865)  he  fell  ill  with 
paranoia  persecutoria  (ideas  of  enemies,  derision  in  the  street,  poison  in 
food ;  obstacles  were  placed  on  the  bridges  to  keep  him  from  going  to  his 
inamorata).  On  account  of  increasing  excitement  and  conflicts  with  those 
about  him  that  he  considered  inimical  to  him,  he  was  taken  to  the  asy- 
lum. At  first  he  presented  the  picture  of  a  typical  paranoia  persecutoria 
with  symptoms  of  sexual,  and  later  general,  neurasthenia,  though  the 
delusions  of  persecution  did  not  rest  upon  this  neurotic  foundation. 
It  was  only  occasionally  that  the  patient  heard  such  sentences  as  this : 
"  Now  the  semen  will  be  drawn  out  of  him.  Now  the  bladder  will  be 
cut  out." 

In  the  course  of  the  years  1866-68,  the  delusions  of  persecution  be- 
came less  and  less  apparent,  and  were  for  the  most  part  replaced  by 
erotic  ideas.  The  somatic  and  mental  basis  was  a  lasting  and  powerful 
excitation  of  the  sexual  sphere.  The  patient  fell  in  love  with  every 
woman  he  saw,  heard  voices  which  told  him  to  approach  her,  and  begged 
to  be  allowed  to  marry,  declaring  that,  if  he  was  not  given  a  wife,  he 
would  waste  away.  With  continuance  of  masturbation,  in  1869,  signs  of 
future  effemination  made  themselves  manifest.  "  He  would,  if  he  should 
get  a  wife,  love  her  only  platonically."  The  patient  grows  more  and  more 
peculiar,  lives  in  a  circle  of  erotic  ideas,  sees  prostitution  practiced  in 
the  asylum,  and  now  and  then  hears  voices  which  impute  immoral  con- 
duct with  women  to  him.  For  this  reason  he  avoids  the  society  of 
women,  and  only  associates  with  them  for  the  sake  of  music  when  two 
witnesses  are  with  him. 

In  the  course  of  the  year  1812,  the  neurasthenic  condition  became 
markedly  increased.  Now  paranoia  persecutoria  again  comes  into  the 
foreground,  and  takes  on  a  clinical  coloring  from  the  neurotic  basis. 
Olfactory  hallucinations  occur.  Magnetic  influences  are  at  work  on  him 
(false  interpretation  of  sensations  due  to  spinal  asthenia).  With  con- 
tinued and  intense  sexual  excitement  and  excess  in  masturbation,  the 
process  of  effemination  constantly  progresses.  Only  episodically  is  he  a 
man  and  inclined  toward  a  woman,  complaining  that  the  shameless  pros- 
titution of  the  men  in  the  house  makes  it  impossible  for  a  lady  to  come  to 
him.  He  is  dying  of  magnetically  poisoned  air  and  unsatisfied  love. 
Without  love  he  cannot  live.  He  is  poisoned  by  lewd  poison  that  affects 
his  sexual  desire.  The  lady  that  he  loves  is  sunk  in  the  lowest  vice. 
The  prostitutes  in  the  house  have  fortune-chains  ;  that  is,  chains  in  which, 
without  moving,  a  man  can  indulge  in  lustful  pleasure.  He  is  ready  now 
to  satisfy  himself  with  prostitutes.  He  is  possessed  of  a  wonderful  ray 
of  thought  that  emanates  from  his  eyes,  which  is  worth  twenty  millions. 
His  compositions  are  worth  500,000  francs.  With  these  indications  of 
delusions  of  grandeur,  there  are  also  those  of  persecution — the  food  is 
poisoned  by  venereal  excrement ;  he  tastes  and  smells  poison,  hears 
infamous  accusations,  and  asks  for  instruments  to  close  his  ears.     From 


ACQUIRED    HOMO-SEXUALITY.  219 

August,  1872,  however,  the  signs  of  effemination  become  more  and  more 
frequent.  He  acts  somewhat  affected,  declaring  that  he  can  no  longer 
live  among  men  that  drink  and  smoke.  He  thinks  and  feels  like  a 
woman.  He  must  thenceforth  be  treated  like  a  woman  and  transferred 
to  a  female  ward.  He  asks  for  confections  and  delicate  desserts.  Occas- 
ionally, on  account  of  tenesmus  and  cystospasm,  he  asks  to  be  transferred 
to  a  lying-in  hospital  and  treated  as  a  woman  very  ill  in  pregnancy.  The 
abnormal  magnetism  of  masculine  attendants  has  an  unfavorable  effect  on 
him.  At  times  he  still  feels  himself  to  be  a  man,  but  in  a  way  which  in- 
dicates his  abnormally  altered  sexual  feeling.  He  pleads  only  for  satis- 
faction by  means  of  masturbation,  or  for  marriage  without  coitus.  Mar- 
riage is  a  sensual  institution.  The  girl  that  he  would  take  for  a  wife 
must  be  a  masturbator.  About  the  end  of  December,  1812,  his  personality 
became  completely  feminine.  From  that  time  he  remained  a  woman.  He 
had  always  been  a  woman,  but  in  his  babjhood  a  French  Quaker,  an 
artist,  had  put  masculine  genitals  on  him,  and  by  rubbing  and  distorting 
his  thorax  had  prevented  the  development  of  his  breasts.  After  this 
he  demanded  to  be  transferred  to  the  female  department,  protection  from 
men  that  wished  to  violate  him,  and  asked  for  female  clothing.  Eventually 
he  also  desired  to  be  given  employment  in  a  toy-shop,  with  crocheting  and 
embroidery  work  to  do,  or  a  place  in  a  dress-making  establishment  with 
female  work.  From  the  time  of  the  transformatio  sexus,  the  patient 
begins  a  new  reckoning  of  time.  He  conceives  his  previous  personality 
in  memory  as  that  of  a  cousin. 

He  always  speaks  of  himself  in  the  third  person,  and  calls  himself 
the  Countess  V.,  the  dearest  friend  of  the  Empress  Eugenie ;  asks  for 
perfumes,  corsets,  etc.  He  takes  the  other  men  of  the  ward  for  girls,  tries 
to  raise  a  head  of  hair,  and  demands  "  Oriental  Hair-Remover,"  in  order 
that  no  one  may  doubt  his  gender.  He  takes  delight  in  praising  onanism, 
for  "she  had  been  an  onanist  from  fifteen,  and  had  never  desired  any 
other  kind  of  sexual  satisfaction."  Occasionall}'  neurasthenic  symptoms, 
olfactory  hallucinations,  and  persecutory  delusions  are  observed.  All 
the  events  up  to  the  time  of  December,  1872,  belong  to  the  personality 
of  the  cousin. 

The  patient's  delusion  that  he  is  the  Countess  V.  can  no  longer  be 
corrected.  She  proves  her  identity  by  the  fact  that  the  nurse  has  ex- 
amined her,  and  finds  her  to  be  a  lady.  The  countess  will  not  marry, 
because  she  hates  men.  Since  he  is  not  provided  with  female  clothing 
and  shoes,  he  spends  the  greatest  part  of  the  day  in  bed,  acts  like  an 
invalid  lady  of  position,  affectedly  and  modestly,  and  asks  for  bon-bons 
and  the  like.  His  hair  is  done  up  in  a  knot  as  well  as  it  allows,  and  the 
beard  is  pulled  out.     Breasts  are  made  out  of  biscuits. 

In  1874  caries  began  in  the  left  knee-joint,  to  which  pulmonary 
tuberculosis  was  soon  added.  Death  on  December  2,  1874.  Skull 
normal.     Frontal  lobes  atrophic.     Brain  anaemic.     Microscopical  (Dr. 


220  PSTCHOPATHIA   SEXUALIS. 

Schiile) :  In  the  superior  layer  of  the  frontal  lobe,  ganglion  cells  some- 
what shrunken;  in  the  adventitia  of  the  vessels, numerous  fat-corpuscles; 
glia  unchanged ;  isolated  pigment  particles  and  colloid  bodies.  The  lower 
layers  of  the  cortex  normal.  Genitals  very  large ;  testicles  small,  lax, 
and  show  no  change  macroscopically  on  section. 

The  delusion  of  sexual  transformation,  displayed,  in  its  con- 
ditions and  phases  of  development,  in  the  foregoing  case,  is  a 
manifestation  remarkably  infrequent  in  the  pathology  of  the 
human  mind.  Besides  the  foregoing  cases,  personally  observed, 
I  have  seen  such  a  case,  as  an  episodical  phenomenon,,  in  a  lady 
having  contrary  sexuality  (Case  92  of  the  sixth  edition  of  this 
work),  one  in  a  girl  affected  with  original  paranoia,  and  another 
in  a  lady  suffering  with  original  paranoia. 

Save  for  a  case  briefly  reported  by  Arndt,  in  his  text-book 
(p.  172),  and  one  quite  superficially  described  by  Serieux 
("  Recherches  Clinique,"  p.  33),  and  the  two  cases  known  to 
Esquirol,  I  cannot  recall  any  cases  of  delusion  of  sexual  trans- 
formation in  literature.  Arndt's  case  may  be  briefly  given  here, 
though,  like  Esquirol's  cases,  it  gives  nothing  concerning  the 
genesis  of  the  delusion  : — 

Case  103.  A  middle-aged  woman  in  the  asylum  at  Greifswald 
thought  she  was  a  man,  and  acted  out  her  belief.  She  cut  her  hair  short, 
and  parted  it  on  one  side  in  the  military  fashion.  A  sharply-cut  pro- 
file, a-  nose  somewhat  large,  and  a  certain  heaviness  of  all  the  features 
gave  the  face  something  characteristic,  and,  in  combination  with  the 
short  hair  combed  smoothly  over  the  ears,  gave  the  whole  head  a  decid- 
edly masculine  appearance.  She  was  tall  and  lean ;  her  voice  low  and 
rough ;  the  larynx  angularly  prominent ;  her  attitude  erect ;  her  gait, 
like  all  her  movements,  heavy,  but  not  awkward.  She  looked  like  a  man 
in  female  dress.  Asked  how  she  had  come  to  think  she  was  a  man,  she 
would  almost  always  cry  excitedly  :  "  Just  look  at  me !  Don't  I  look 
like  a  man  ?  I  feel  like  a  man,  too.  I  have  always  felt  so,  but  I  only 
gradually  came  to  understand  it  clearly.  The  man  who  should  be  my 
husband  is  not  a  real  man.  I  raised  my  children  myself.  I  always  felt 
somewhat  like  this,  but  I  came  to  understand  later.  Did  I  not  always 
work  like  a  man  ?  The  man  who  passed  for  my  husband  only  helped. 
He  did  what  I  planned.  From  my  youth  I  have  been  more  masculine 
than  feminine.  I  have  always  had  more  liking  for  the  garden  and  farm 
than  for  work  in  the  house  and  kitchen.  But  I  never  understood  the 
reason.  Now  I  know  I  am  a  man,  and  I  shall  bear  myself  like  pne.  It 
is  a  shame  to  make  me  always  wear  women's  clothes." 


ACQUIRED    HOMOSEXUALITY.  221 

Case  104.  X.,  aged  26,  tall,  and  of  handsome  appearance.  Since 
his  earliest  youth  he  has  loved  to  wear  female  attire.  As  he  grew  up,  he 
managed  it  so  that,  when  he  was  a  participant  in  theatricals,  he  always 
had  a  female  part.  After  an  attack  of  mental  excitement,  he  imagined 
that  he  was  actually  a  woman,  and  tried  to  convince  others  of  it. 

lie  liked  to  undress  himself,  and  dress  his  hair  and  put  on  female 
clothing.  In  this  state  he  wished  to  go  out  on  the  street.  In  other 
respects  he  was  perfectly  reasonable.  He  would  spend  the  whole  day 
arranging  his  hair  and  looking  at  himself  in  the  glass,  costuming  himself 
in  a  night-dress  as  much  like  a  woman  as  possible.  In  walking  he 
imitated  women.  One  day,  when  Esquirol  acted  as  if  about  to  lift  up 
his  dress,  he  flew  into  a  passion  and  upbraided  him  for  his  want  of 
modesty  (Esquirol). 

Case  105.  Mrs.  X.,  widow.  Owing  to  the  death  of  her  husband 
and  loss  of  fortune,  she  had  been  greatly  troubled  in  mind.  She  became 
disturbed  mentally,  and  was  admitted  to  the  Salpetriere  after  attempting 
suicide. 

Mrs.  X.,  lean,  thin ;  constantly  maniacal ;  she  believes  herself  a 
man,  and  flies  angry  if  she  is  addressed  as  "  madam."  Once,  when  male 
clothing  was  placed  at  her  disposal,  she  was  beside  herself  with  joy.  She 
died,  in  1802,  of  a  consumptive  malady;  and  she  expressed  her  delusion 
of  being  a  man  until  shortly  before  her  death  (Esquirol). 

I  have  already  mentioned  the  interesting  relations  existing 
between  the  facts  of  delusional  transformation  of  sex  and  the 
so-called  insanity  of  the  Scythians. 

Marandon  ("  Annales  medico-psychologiques,"  1877,  p. 
161),  like  others,  has  erroneously  presumed  that  with  the  ancient 
Scythians  there  was  an  actual  delusion,  and  that  the  condition 
was  not  merely  that  of  eviration'.  According  to  the  law  of  em- 
pirical actuality,  the  delusion,  so  infrequent  to-day,  must  also  have 
been  very  infrequent  in  ancient  times.  Since  it  can  only  be  con- 
ceived as  arising  on  the  basis  of  a  paranoia,  there  can  be  no 
thought  of  its  endemic  occurrence ;  it  can  only  be  regarded  as 
a  superstitious  manifestation  of  eviration  (the  result  of  anger 
of  the  goddess),  as  is  also  evident  from  the  statements  of 
Hippocrates. 

The  facts  of  the  so-called  Scythian  insanity,  as  well  as  the 
facts  lately  learned  about  the  Pueblo  Indians,  are  also  note- 
worthy anthropologically,  in  that  atrophy  of  the  testes  and  geni- 
tals in  general,  and  approximation  to  the  female  type,  physically 


222  PSYCHOPATHIA    SEXUALIS. 

and  mentally,  were  observed.  This  is  the  more  remarkable,  since, 
in  men  who  have  lost  their  procreative  organs,  such  a  reversal 
of  instinct  is  quite  as  unusual  as  in  women,  mutatis  mutandis, 
after  the  natural  or  artificial  climacteric. 

B.  Homo- Sexual  Feeling  as  an  Abnormal  Congenital 
Manifestation} — The  essential  feature  of  this  strange  manifesta- 
tion of  the  sexual  life  is  the  want  of  sexual  sensibility  for  the 
opposite  sex,  even  to  the  extent  of  horror,  while  sexual  inclina- 
tion and  impulse  toward  the  same  sex  are  present.  At  the  same 
time,  the  genitals  are  normally  developed,  the  sexual  glands 
perform  their  functions  properly,  and  the  sexual  type  is 
completely  differentiated. 

Feeling,  thought,  will,  and  the  whole  character,  in  cases  of 
the  complete  development  of  the  anomaly,  correspond  with 
the  peculiar  sexual  instinct,  but  not  with  the  sex  which  the 
individual  represents  anatomically  and  physiologically.  This 
abnormal  mode  of  feeling  may  not  infrequently  be  recognized 
in  the  manner,  dress,  and  calling  of  the  individuals,  who  may 
go  so  far  as  to  yield  to  an  impulse  to  don  the  distinctive  clothing 
corresponding  with  the  sexual  role  in  which  they  feel  them- 
selves to  be. 

Anthropologically  and  clinically,  this  abnormal  manifesta- 
tion presents  various  degrees  of  development : — 

1.  Traces  of  hetero-sexual,  with  predominating  homo- 
sexual, instinct  (psycho-sexual  hermaphroditism). 

2.  There  exists  inclination  only  toward  the  same  sex 
(homo-sexuality). 

1  Bibliography  (besides  works  mentioned  hereafter)  :  Tardieu,.  Des  attentats  aux 
moeurs,  7  edit.,  1878,  p.  210.— Hofmann,  Lehrb.  d.  ger.  Med.,  3  Aufl.,  pp.  172,  850.— Gley, 
Revue  philosophique,  1884,  Nr.  1. — Magnau,  Annal.  med.-psychol.,  1885,  p.  458. — Shaw  and 
Ferris,  Journal  of  Nervous  and  Mental  Disease,  1883,  April. — Bernhardt,  Der  Uranismus, 
Berlin  (Volksbuchhandlung),  1882. — Chevalier,  De  1  Inversion  de  l'instinct  sexual,  Paris, 
1885. — Ritti,  Gaz.  hebdom.  de  medecine  et  de  chirurg.,  1878, 4.  Januar. — Tamassia,  Rivista 
sperim,  1878,  pp.  97-117. — Lombroso,  Archiv.  di  Psichiatr.,  1881. — Charcot  et  Magnan, 
Archiv.  de  neurologie,  1882,  Nr.  7,  12. — Moll,  Die  eontrare  Sexualempfiudung,  Berlin,  1891 
(numerous  bibliographic  references). — Chevalier,  Archives  de  1 'anthropologic  criminelle, 
vol.  v,  No  27 ;  vol.  vi,  No.  31. — Reuss, "  Aberrations  du  sens  generique,"  Annales  d'hygiene 
publique,  1886. — Saury,  Etude  cliuique  sur  la  folie  hercditaire,  18S6. — Brouardel,  Gaz.  des 
hopiteaux,  1886  and  1887. — Tilier,  L'instinct  sexuel  chez  l'honime  et  chez  les  animaux, 
1889. — Carlier,  Les  deux  prostitutions,  1887. — Lacassagne,  art.  "  Pederastie,"in  the  Diction, 
encyclopedique. — Vibert,  art.  "  Pederastie,"  in  the  Diction,  med.  et  de  chirurgie, 


CONGENITAL   HOMO-SEXUALITY.  223 

3.  The  entire  mental  existence  is  altered  to  correspond 
with  the  abnormal  sexual  instinct  (effemination  and  viraginity). 

4.  The  form  of  the  body  approaches  that  which  corresponds 
to  the  abnormal  sexual  instinct.  However,  actual  transitions 
to  hermaphrodites  never  occur,  but,  on  the  contrary,  completely 
differentiated  genitals ;  so  that,  just  as  in  all  pathological  per- 
versions of  the  sexual  life,  the  cause  must  be  sought  in  the 
brain  (androgyny  and  gynandry). 

The  first  definite  communications l  concerning  this  enigmatical  phe- 
nomenon of  Nature  are  made  by  Caspar  ("  Ueber  Nothzucht  und  Piider- 
astie,"  Caspar's  Vierteljahrsschrift,  1852,  i),  who,  it  is  true,  classes  it 
with  pederasty,  but  makes  the  pertinent  remark  that  this  anomaly  is,  in 
most  cases,  congenital,  and,  at  the  same  time,  to  be  regarded  as  a  mental 
hermaphroditism.  There  exists  here  an  actual  disgust  of  sexual  contact 
with  women,  while  the  imagination  is  filled  with  beautiful  young  men, 
and  with  statues  and  pictures  of  them.  It  did  not  escape  Casper  that  in 
such  cases  emissio  penis  in  anum  (pederasty)  is  not  the  rule,  but  that,  by 
means  of  other  sexual  acts  (mutual  onanism),  sexual  satisfaction  is 
sought  and  obtained. 

In  his  "  Clinical  Novels  "  (1863,  p.  33)  Casper  gives  the  interesting 
confession  of  a  man  showing  this  perversion  of  the  sexual  instinct,  and 
does  not  hesitate  to  assert  that,  aside  from  vicious  imagination  and  vice, 
as  a  result  of  over-indulgence  in  normal  sexual  intercourse,  there  are 
numerous  cases  in  which  pederasty  has  its  origin  in  a  remarkable,  obscure 
impulse,  which  is  congenital  and  inexplicable.  About  the  middle  of  the 
"  sixties,"  a  certain  assessor,  Ulrichs,  himself  subject  to  this  perverse 
instinct,  came  out  and  declared,  in  numerous  articles,2  that  the  sexual 

1  Dr.  Moll,  of  Berlin,  called  my  attention  to  the  fact  that  in  Moritz's  Magazin  f. 
Erfahrungsseelenkunde,  vol.  viii,  Berlin,  1791,  there  are  references  to  contrary  sexual 
instinct  in  man.  In  fact,  there  two  biographies  of  men  are  reported  who  manifested  au 
enthusiastic  love  for  persons  of  their  own  sex.  In  the  second  case,  which  is  particularly 
noteworthy,  the  patient  himself  explains  his  aberration  by  the  fact  that,  as  a  child,  he  was 
caressed  only  by  grown  persons,  and,  as  a  boy  of  ten  or  twelve  years,  only  by  his  school- 
fellows. "This,  and  the  want  of  association  with  persons  of  the  opposite  sex,  in  me, 
caused  the  natural  inclination  toward  the  female  sexto  be  entirely  diverted  to  the  male  sex. 
I  am  still  quite  indifferent  to  women." 

It  cannot  be  determined  whether  such  a  case  is  one  of  congenital  (psycho-sexual 
hermaphroditism  ?)  or  acquired  contrary  sexual  instinct.  The  oldest  case  of  contrary 
sexual  instinct,  that  has  thus  far  been  proved  in  Germany,  is  that  of  a  woman  who  was 
married  to  another,  and  gratified  herself  sexually  with  a  leathern  priapus.  A  case  of  vira- 
ginity, historically  and  legally  interesting,  derived  from  the  legal  proceedings,  which  took 
place  early  in  the  eighteenth  century,  is  reported  by  Dr.  Muller  (Alexandersbad),  in  Fried- 
rich's  Blatter  f.  ger.  Medicin,  1891,  part  iv. 

2  "  Vindex,  Inclusa,  Vindicta,  Formatrh:,  Ara  spei,  Gladius  furens,  kritische  Pfeile," 
Leipzig  (Otto  u.  Kadler),  1864-1880. 


224  PSYCHOPATHIA   SEXUALIS. 

mental  life  was  not  connected  with  the  bodily  sex ;  that  there  were  male 
individuals  that  felt  like  women  toward  men  ("  anima  muliebris  in  corpore 
virili  inclusa  ").  He  called  these  people  "  urnings"  and  demanded  nothing 
less  than  the  legal  and  social  recognition  of  this  sexual  love  of  the  urn- 
ings  as  congenital  and,  therefore,  as  right ;  and  the  permission  of  mar- 
riage among  them.  Ulrichs  failed,  however,  to  prove  that  this  certainly 
congenital  and  paradoxical  sexual  feeling  was  physiological,  and  not 
pathological. 

Griesinger  (Archiv  f,  Psychiatrie,  i,  p.  651)  threw  the  first  ray 
of  light  on  these  facts,  anthropologically  and  clinically,  by  pointing  out 
the  marked  hereditary  taint  of  the  individual,  in  a  case  which  came  under 
his  own  observation. 

We  have  Westphal  (Archiv  f.  Psychiatrie,  ii,  p.  13)  to  thank 
for  the  first  systematic  consideration  of  the  manifestation  in  question, 
which  he  defined  as  "  congenital  reversal  of  the  sexual  feeling,  with 
consciousness  of  the  abnormality  of  the  manifestation,"  and  designated 
with  the  name,  since  generally  accepted,  of  contrary  sexual  instinct.  At 
the  same  time,  he  began  a  series  of  cases,1  which,  up  to  this  time,  has 
reached  ninety -three,  those  reported  in  this  monograph  not  being  included. 

Westphal  leaves  it  undecided  as  to  whether  contrary  sexual  feeling 
is  a  symptom  of  a  neuropathic  or  of  a  psychopathic  condition,  or  whether 

1  In  male  individuals  :  (1)  Casper,  Klin.  Novellen,  p.  36  (Lehrb.  d.  ger.  Med.,  7 
Aufl.,  p.  176);  (2)  Westphal,  Archiv  f.  Psych.,  ii.  p.  73;  (3)  Schminke,  id.,  iii,  p.  225; 
(4)  Scholz,  Vierteljahrsschr.  f.  ger.  Med.,xix ;  (5)  Gock,  Arch.  f.  Psych.,  v.,  p.  564;  (6)  Ser- 
vaes,  id.,  vi,  p.  484;  (7)  Westphal,  id.,vi,  620;  (8,9,10)  Stark,  Zeitsch.  f.  Psychiatrie, 
Bd.  31 ;  (11)  Liman  (Casper's  Lehrb.  der  ger.  Med.,  6  Aufl.,  p.  509),  p.  291 ;  (12)  Legrand 
du Saulle,  Annal.  m6d.-psyehol.,  1876,  May ;  (13)  Sterz,  Jahrb.  f.  Psychiatrie,  iii,  Heft3  ;  (14) 
Krueg,  Brain,  1884,  Oct. ;  (15)  Charcot  et  Magnan,  Arch,  de  neurolog.,  1882,  Nr.  9;  (16, 
17,  18)  Kirn,  Zeitschr.  f.  Psych.,  Bd.  39,  p.  216;  (19)  Rabow,  Erlenmeyer's  Centralb.,1883^ 
Nr.  8;  (20)  Blumer,  Americ.  Journ.  of  Insanity,  1882,  July;  (21)  Savage,  Journal  of 
Mental  Science,  1884,  October;  (22)  Scholz,  Vierteljahrsschr.  f.  ger.  Med.,  N.  F.  Bd.43, 
Heft.  7;  (23)  Magnan,  Ann.  m6d.  psychol.,  1885,  p.  461;  (24)  Chevalier,  De  l'inversion 
de  l'instinct  sexuel,  Paris,  1885,  p.  129 ;  (25)  Morselli,  La  Riforma  medica,  iv,  March ;  (26) 
Leonpacher,  Friedreich's  Blatter,  1888,  H.  4;  (27)  Hollander,  Allg.  Wiener  Med.  Zeits;., 
1882;  (28)  Kreise,  Erlenmeyer's  Centralblatt,  1888,  Nr.  19;  (29,  30,  31,  32)  v.  Krafft,  Psy- 
chopathia  sexualis,  3  Aufl.,  Beob.  32,  36,  42. 43 ;  (33)  Golenko,  Russ.  Archiv  f.  Psychiatrie, 
Bd.  ix,  H.  3  (v.  Rothe,  Zeitschr.  f.  Psychiatrie)  ;  (34)  v.  Krafft,  Internationales  Centralblatt 
f.  d.  Physiol,  u.  Pathologie  der  Harn-u.  Sexualorgane,  Bd.  1,  H.  1 ;  (35)  Cantarano,  La 
Psichiatria,  1887,  v.,  p.  195;  (36)  Serieux,  Recherches  cliniques  sur  les  anomalies  de 
l'instinct  sexuel,  Paris,  1888,  obs.  13;  (37-42)  Kiernan,  The  Medical  Standard,  1888,  7 
cases ;  (43-46)  Rabow,  Zeitschr.  f.  klin.  Medicin,  Bd.  xvii,  Suppl. ;  (47-51)  v.  Krafft,  Neue 
Forschungen,  Beob.  1,  3,  4,  5,  8)  ;  (52-61)  v.  Krafft,  Psychopath.  Sexualis,  5  Aufl.,  Beob. 
53,  61,  64,  66,  73,  75,  78,  84,  85,  87 ;  (62-65)  v.  Krafft,  Neue  Forschungen,  2  Aufl.,  Beob.  3, 
4,  5,  6;  (66,  67)  Hammond,  Sexual  Impotence;  (68-71)  Gamier,  Anomalies  sexuellcs, 
1889,  Obs.  227,  228,  229,  230;  (72)  Miiller,  Friedreich's  Blatter,  1891;  (73-87)  v.  Krafft., 
Psychopathia  Sexualis,  6  Aufl.,  Beob.78,  81,  82, 84,  85,  86,  87, 89,  93,  94, 96,  97,  98, 101,  102. 

In  female  individuals  :  (1)  Westphal,  Arch.  f.  Psych.,  ii,  p.  73;  Gock,  op.  cit.,  Nr. 
1 ;  (3)  Wise,  The  Alienist  and  Neurologist,  1883,  January;  (4)  Cantarano,  La  Psichiatria, 
1883,  p.  201 ;  (5)  Serieux,  op.  cit.,  obs.  14;  (6)  Kiernan,  op.  cit. 


CONGENITAL   HOMO-SEXUALITY.  225 

it  may  occur  as  an  isolated  manifestation.     He  holds  fast  to  the  opinion 
that  the  condition  is  congenital. 

From  the  cases  published  up  to  1877,  I  have  designated 
this  peculiar  sexual  feeling  as  a  functional  sign  of  degeneration, 
and  as  a  partial  manifestation  of  a  neuro-psychopathic  state,  in 
most  cases  hereditary, — a  supposition  which  has  found  renewed 
confirmation  in  a  consideration  of  additional  cases.  The  follow- 
ing peculiarities  may  be  given  as  the  signs  of  this  neuro- 
psychopathic taint : — 

1.  The  sexual  life  of  individuals  thus  organized  manifests 
itself,  as  a  rule,  abnormally  early,  and  thereafter  with  abnormal 
power.  Not  infrequently  still  other  perverse  manifestations  are 
presented  besides  the  abnormal  method  of  sexual  satisfaction, 
which  in  itself  is  conditioned  by  the  peculiar  sexual  feeling. 

2.  The  psychical  love  manifest  in  these  men  is,  for  the  most 
part,  exaggerated  and  exalted  in  the  same  way  as  their  sexual 
instinct  is  manifested  in  consciousness,  with  a  strange  and  even 
compelling  force. 

3.  By  the  side  of  the  functional  signs  of  degeneration 
attending  contrary  sexual  feeling  are  found  other  functional, 
and  in  many  cases  anatomical,  evidences  of  degeneration. 

4.  Neuroses  (hysteria,  neurasthenia,  epileptoid  states,  etc.) 
co-exist.  Almost  always  the  existence  of  temporary  or  lasting 
neurasthenia  may  be  proved.  As  a  rule,  this  is  constitutional, 
having  its  root  in  congenital  conditions.  It  is  awakened  and 
maintained  by  masturbation  or  enforced  abstinence. 

In  male  individuals,  owing  to  these  practices  or  to  congeni- 
tal disposition,  there  is  finally  neurasthenia  sexualis,  which  mani- 
fests itself  essentially  in  irritable  weakness  of  the  ejaculation 
centre.  Thus  it  is  explained  that, 'in  most  of  the  cases,  simply 
embracing  and  kissing,  or  even  only  the  sight  of  the  loved  per- 
son, induce  the  act  of  ejaculation.  Frequently  this  is  accom- 
panied by  an  abnormally  powerful  feeling  of  lustful  pleasure, 
which  may  be  so  intense  as  to  suggest  a  feeling  of  magnetic 
currents  passing  through  the  body. 

5.  In  the  majority  of  cases,  psychical  anomalies  (brilliant 
endowment  in  art,  especially  music,  poetry,  etc.,  by  the  side  of 


226  PSYCHOPATHIA   SEXUALIS. 

bad  intellectual  powers  or  original  eccentricity)  are  present, 
which  may  even  go  so  far  as  pronounced  conditions  of  mental 
degeneration  (dementia,  moral  insanity). 

In  many  urnings,  either  temporarily  or  permanently,  in- 
sanity of  a  degenerative  character  (pathological  emotional  states, 
periodical  insanity,  paranoia,  etc.)  makes  its  appearance. 

6.  In  almost  all  cases  where  an  examination  of  the  physical 
and  mental  peculiarities  of  the  ancestors  and  blood-relations  has 
been  possible,  neuroses,  psychoses,  degenerative  signs,  etc.,  have 
been  found  in  the  families.1 

The  depth  of  congenital  contrary  feeling  is  shown  by 
the  fact  that  the  lustful  dream  of  the  male-loving  urning  has 
for  its  content  only  male  individuals ;  that  of  the  female-loving 
woman,  only  female  individuals,  with  corresponding  situations. 

The  observation  of  Westphal,  that  the  consciousness  of  one 
congenitally  defective  in  sexual  desires  toward  the  opposite  sex 
is  painfully  affected  by  the  impulse  toward  the  same  sex,  is 
true  in  only  a  number  of  cases.  Indeed,  in  many  instances, 
the  consciousness  of  the  abnormality  of  the  condition  is  want- 
ing. The  majority  of  urnings  are  happy  in  their  perverse  sex- 
ual feeling  and  impulse,  and  unhappy  only  in  so  far  as  social 
and  legal  barriers  stand,  in  the  way  of  the  satisfaction  of  their 
instinct  toward  their  own  sex. 

The  study  of  contrary  sexual  feeling  points  directly  to 
anomalies  of  the  cerebral  organization  of  the  affected  individu- 
als. Gley  (Revue  philosoph.,  January,  1884)  believes  that  he  is 
able  to  solve  the  riddle  by  the  theory  that  the  individuals  have 
a  female  brain  and  male  sexual  glands ;  and,  further,  that  path- 
ological brain  conditions  determine  the  sexual  life,  while  nor- 
mally the  sexual  organs  determine  the  sexual  functions  of  the 
brain. 

One  of  my  patients  offered  me  an  interesting  theory  in 


1  Tarnowsky  (op.  cit.,  p.  34)  records  a  case  which  shows  that  contrary  sexual  feeling, 
as  a  concomitant  manifestation  with  neurotic  degeneration,  may  also  affect  the  descendants 
of  parents  having  no  neurotic  taint.  In  this  instance,  lues  of  the  parents  played  a  part,  as 
in  a  similar  case  of  Scholz  (Vierteljahrsschr.  f.  ger.  Med.),  in  which  the  perversion  of  the 
sexual  desires  stood  in  causal  relation  with  an  arrest  of  psychical  development,  caused  by 
traumatism, 


CONGENITAL   HOMO- SEXUALITY.  227 

explanation  of  original  contrary  sexual  instinct.  He  started 
with  the  actual  bi-sexuality  shown  by  the  foetus  anatomically 
up  to  a  certain  age.  While  normally  the  organs  which  attain 
complete  development  exclusively  condition  and  determine  the 
sexual  type,  and  the  influence  of  the  opposite  organs,  which 
remain  rudimentary,  is  nil,  it  is  conceivable  that,  under  the 
influence  of  a  factor  inimical  to  the  normal  development  of 
the  brain  (hereditary  taint,  etc.),  these  rudimentary  organs  like- 
wise exercise  an  influence  which,  under  certain  circumstances, 
may  be  even  greater  than  that  of  the  fully  developed  organs 
which  determine  the  external  sexual  type. 

In  a  similar  manner,  Kiernan  {Medical  Standard,  1888) 
and  G.  Frank  Lydston  {Phila.  Med.  and  Surg.  Reporter,  1888) 
attempt  to  explain  a  part  of  the  cases  of  congenital  sexual 
paranoia.  Magnan,  too  {Ann.  med.  psycliol.,  1885,  p.  458), 
writes,  in  all  earnestness,  of  the  brain  of  a  woman  in  the  body 
of  a  man,  and  vice  versa.1 

The  attempted  explanations  of  congenital  timings  are  not 
less  superficial ;  for  instance,  that  of  Ulrichs,  who,  in  his 
"  Memnon,"  1868,  speaks  of  an  "  anima  muliebris  virili  corpore 
inclusa  (virili  corpori  innata),"  and  thus  tries  to  explain  the 
congenital  origin  and  the  female  character  of  bis  abnormal  sex- 
ual instinct.  The  idea  of  the  patient,  the  subject  of  Case  124, 
is  original.  He  supposes  that  when  his  father  begat  him  he 
thought  to  beget  a  girl,  but,  instead  of  a  girl,  a  boy  resulted. 
One  of  the  strangest  explanations  of  congenital  contrary  sexual 
feeling  is  made  by  Mantegazza  {op.  cit.,  p.  106,  1886). 

According  to  this  author,  in  such  individuals  there  exist 
anatomical  anomalies  which,  by  an  error  of  Nature,  consist  in  a 
distribution  to  the  rectum  of  the  nerves  intended  for  the  geni- 
tals ;  so  that  only  in  this  situation  the  lustful  sensation  is 
aroused  which  otherwise  results  from  stimulation  of  the  geni- 
tals. But  how  does  this  author,  in  other  ways  so  acute,  ex- 
plain the  great  majority  of  cases,  where  pederasty  is  abhorred  by 
those  affected  with  contrary  sexual  feeling'?     Besides,  Nature 

1  This  supposition  is  overthrown  by  the  result  of  the  post-mortem  of  my  case  (118), 
where  the  brain-weight  was  1150  grammes,  and  of  Case  130,  where  it  was  1175  grammes. 


228  PSYCHOPATHIA   SEXUALIS. 

never  makes  such  leaps.  Mantegazza  rests  his  hypothesis  upon 
the  statements  of  an  acquaintance,  a  celebrated  writer,  who 
assured  him  that  he  was  not  sure  that  he  took  a  greater  pleasure 
in  coitus  than  in  defecation !  Allowing  the  correctness  of  his 
experience,  still  it  would  only  prove  that  the  man  was  sexually 
abnormal,  and  that  his  pleasure  in  coitus  was  reduced  to  a 
minimum. 

An  explanation  of  congenital  contrary  sexual  feeling  may 
perhaps  be  found  in  the  fact  that  it  represents  a  peculiarity  bred 
in  descendants,  but  arising  in  ancestry.  The  hereditary  factor 
might  be  an  acquired  abnormal  inclination  for  the  same  sex 
in  the  ancestors  (v.  infra),  found  fixed  as  a  congenital  ab- 
normal manifestation  in  the  descendants.  Since,  according 
to  experience,  acquired  physical  and  mental  peculiarities,  not 
simply  improvements,  but  essentially  defects,  are  transmitted, 
this  hypothesis  becomes  tenable.  Since  individuals  affected 
with  contrary  sexual  feeling  not  infrequently  beget  children, — 
at  least,  they  are  not  absolutely  impotent  (women  never  are), — 
a  transmission  to  descendants  is  possible. 

This  supposition  is  decidedly  favored  by  Case  124,  in 
which  the  eight-year-old  daughter  of  an  individual  affected 
with  contrary  sexual  feeling,  practiced  mutual  masturbation — 
a  sexual  act — at  an  age  which  permits  the  presumption  of  con- 
trary sexual  feeling.  No  less  significant  is  the  communication 
made  to  me  by  a  young  man  of  twenty-six,  who  belongs  to  the 
third  group  of  contrary  sexuality.  He  knew  with  certainty 
that  his  father,  who  had  died  some  years  before,  was  also  sub- 
ject to  contrary  sexuality.  An  informant  assured  me,  at  least, 
that  he  knew  many  other  men  with  whom  his  father  had  sus- 
tained "  relations."  Whether,  in  the  case  of  the  father,  it  was 
an  acquired  or  a  congenital  contrary  sexual  instinct,  and  to 
what  group  he  belonged,  could  not  be  ascertained. 

The  foregoing  hypothesis  seems  the  more  plausible,  when 
it  is  considered  that  the  first  three  degrees  of  congenital  con- 
trary sexual  instinct  correspond  exactly  with  the  developmental 
stages  which  are  discoverable  in  the  development  of  the 
acquired  anomaly.     One,  therefore,  feels  inclined  to  designate 


CONGENITAL   HOMO-SEXUALITY.  229 

the  various  degrees  of  congenital  contrary  sexual  instinct  as 
various  degrees  of  an  hereditarily-induced  sexual  anomaly, 
acquired  from  the  progenitors  or  otherwise  developed.  Here, 
too,  the  law  of  progressive  heredity  must  be  taken  into  con- 
sideration. 

The  sexual  acts,  by  means  of  which  male  urnings  seek  and 
find  satisfaction,  are  multifarious.  There  are  individuals,  of  fine 
feeling  and  strength  of  will,  who  sometimes  satisfy  themselves 
with  platonic  love,  with  the  risk,  however,  of  becoming  nervous 
(neurasthenic)  and  insane,  as  a  result  of  this  enforced  absti- 
nence. In  other  instances,  for  the  same  reasons  which  may 
lead  normal  individuals  to  avoid  coitus,  onanism,  faut  de  mieux, 
is  indulged  in. 

In  urnings  with  nervous  systems  congenitally  irritable,  or 
injured  by  onanism  (irritable  weakness  of  the  ejaculation 
centre),  simple  embraces  or  caresses,  with  or  without  contact  of 
the  genitals,  are  sufficient  to  induce  ejaculation  and  consequent 
satisfaction.  In  less  irritable  individuals,  the  sexual  act  consists 
of  manustupration  by  the  loved  person,  or  mutual  onanism,  or 
imitation  of  coitus  between  the  thighs.  In  urnings  morally 
perverse  and  potent,  quoad  erectionem,  the  sexual  desire  is  satis- 
fied by  pederasty, — an  act,  however,  which  is  repugnant  to  per- 
verted individuals  that  are  not  defective  morally,  much  in  the 
same  way  as  it  is  to  normal  men.  The  statement  of  urnings  is 
remarkable,  that  the  sexual  act  with  persons  of  the  same  sex, 
which  is  adequate  for  them,  gives  them  a  feeling  of  great  satis- 
faction and  accession  of  strength,  while  satisfaction  by  solitary 
onanism,  or  by  enforced  coitus  with  a  woman,  affects  them  in  an 
unfavorable  way,  making  them  miserable  and  increasing  their 
neurasthenic  symptoms.  The  manner  of  satisfaction  of  the  female 
miling  is  little  known.  In  one  of  my  cases,  the  girl  mastur- 
bated, and  during  the  act  felt  herself  to  be  a  man ;  and  her 
fancy  created  a  beloved  female  person.  In  another  case,  the  act 
consisted  of  practicing  onanism  on  the  person  loved,  and  fond- 
ling her  genitals. 

Amor  lesbicus  is  presumably  not  infrequent  here,  for  which 
an  enlarged  clitoris  or  an  artificial  priapus  may  be  used. 


230  PSYCHOPATHIA   SEXUALIS. 

As  to  the  frequency1  of  the  occurrence  of  the  anomaly,  it 
is  difficult  to  reach  a  just  conclusion,  since  those  affected  with 
it  break  from  their  reserve  only  very  infrequently ;  and  in  crimi- 
nal cases  the  tuning  with  perversion  of  sexual  instinct  is  usually 
classed  with  the  person  given  to  pederasty  for  simply  vicious 
reasons.  According  to  Casper's  and  Tardieu's,  as  well  as  my 
own,  experience,  this  anomaly  is  much  more  frequent  than 
reported  cases  would  lead  us  to  presume. 

Ulrichs  ("Kritische  Pfeile,"  p.  2,  1880)  declares  that,  on 
an  average,  there  is  one  person  affected  with  contrary  sexual 
instinct  to  every  two  hundred  mature  men,  or  to  every  eight 
hundred  of  the  population ;  and  that  the  percentage  among  the 
Magyrs  and  South  Slavs  is  still  greater, — statements  which  may 
be  regarded  as  untrustworthy.  The  subject  of  one  of  my  cases 
knows  personally,  at  his  home  (13,000  inhabitants),  fourteen 
urnings.  He  further  declares  that  he  is  acquainted  with  at  least 
eighty  in  a  city  of  60,000  inhabitants.  It  is  to  be  presumed 
that  this  man,  otherwise  worthy  of  belief,  makes  no  distinction 
between  the  congenital  and  the  acquired  anomaly. 

1.  Psychical  Hermaphroditism.2 — The  characteristic  mark 
of  this  degree  of  inversion  of  the  sexual  instinct  is  that,  by  the 
side  of  the  pronounced  sexual  instinct  and  desire  for  the  same 
sex,  a  desire  toward  the  opposite  sex  is  present ;  but  the  latter 
is  much  weaker  and' is  manifested  episodically  only,  while  the 
homo-sexuality  is  primary,  and,  in  time  and  intensity,  forms  the 
most  striking  feature  of  the  vita  sexualis. 


1  That  inversion  of  the  sexual  instinct  is  not  infrequent  is  proved,  amongother  things, 
by  the  circumstance  that  it  is  frequently  a  subject  in  novels.  Chevalier  (op.  cit.)  points 
out  in  French  literature,  besides  the  novels  of  Balzac,  like  "  La  Passion  au  Desert"  (treating 
of  bestiality)  and  "  Sarraziue"  (treating  of  the  love  of  a  woman  for  a  eunuch),  Diderot's  "  La 
Religieuse  "  (a  story  of  one  given  to  amor  lesbian);  Balzac's  "  La  Filleaux  Yeuxd 'Or  "  (amor 
lesbicus);  Th.  Gauticr's  "  Mademoiselle  de  Maupin  " ;  Feydeau's  "  La  Comtesse  de  Chalis  "  ; 
Flaubert's  "  Salammbo,"etc.  Belot's  "  Mademoiselle  Oiraud,  Ma  Femme"  may  also  be  men- 
tioned (now  translated  into  English).  It  is  interesting  that  the  heroines  of  these  (Lesbian) 
novels  appear  in  the  character  and  role  of  the  husband  of  a  lover  of  the  same  sex,  and  that 
their  love  is  extremely  passionate.  Moreover,  the  neuropathic  foundation  of  this  sexual  per- 
version does  not  escape  the  writers. .  This  theme  is  treated,  in  German  literature,  in  "  Fri- 
dolin's  heimliche  Ehe,"  by  Wilbrand  ;  in  "  Brick  and  Brack  oder  Licht  in  Schatten,"  by 
Emerich  Graf  Stadion.  The  oldest  urning's  romance  is  probably  that  published  by  Petronius 
at  Rome,  under  the  Empire,  under  the  title  Satyricon. 

2  Comp.  author's  work,  "  Ueber  psychosexuales  Zwitterthum,"  in  the  internationalen 
Centralblatt  f.  d.  Physiologie  u.  Pathologie  der  Harn  und  Sexualorgane,  Bd.  i,  Heft  2. 


CONGENITAL   HOMO-SEXUALITY.  231 

The  heterosexual  instinct  may  be  but  rudimentary,  mani- 
festing itself  simply  in  unconscious  (dream)  life;  or  (episodically, 
at  least)  it  may  be  powerfully  exhibited. 

The  sexual  instinct  toward  the  opposite  sex  may  be  strength- 
ened by  the  exercise  of  will  and  self-control ;  by  moral  treatment, 
and  possibly  by  hypnotic  suggestion  ;  by  improvement  of  the 
constitution  and  the  removal  of  neuroses  (neurasthenia) ;  but 
especially  by  abstinence  from  masturbation.  However,  there  is 
always  the  danger  that  homo-sexual  feelings,  in  that  they  are 
the  most  powerful,  may  become  permanent,  and  lead  to  endur- 
ing and  exclusive  contrary  sexual  instinct.  This  is  especially  to 
be  feared  as  a  result  of  the  influences  of  masturbation  (just  as 
in  acquired  inversion  of  the  sexual  instinct)  and  its  neurasthenia 
and  consequent  exacerbations  ;  and,  further,  it  is  to  be  found 
as  a  consequence  of  unfavorable  experiences  in  sexual  inter- 
course with  persons  of  the  opposite  sex  (defective  feeling  of 
pleasure  in  coitus,  failure  in  coitus  on  account  of  weakness  of 
erection  and  premature  ejaculation,  infection).  On  the  other 
hand,  it  is  possible  that  aesthetic  and  ethical  sympathy  with 
persons  of  the  opposite  sex  may  favor  the  development  of  hetero- 
sexual desires.  Thus  it  happens  that  the  individual,  according 
to  the  predominance  of  favorable  or  unfavorable  influences, 
experiences  now  hetero-sexual,  now  homo-sexual,  feeling. 

It  seems  to  me  probable  that  such  hermaphrodites  from 
constitutional  taint  are  not  infrequent.1  Since  they  attract  very 
little  attention  socially,  and  since  such  secrets  of  married  life 
are  only  exceptionally  brought  to  the  knowledge  of  the  phy- 
sician, it  is  at  once  apparent  why  this  interesting  and  practically 
important  transitional  group  to  the  group  of  absolute  contrary 
sexuality,  has  thus  far  escaped  scientific  investigation.  Many 
cases  of  frigiditas  uxoris  and  mariti  may  possibly  depend  upon 
this  anomaly.  Sexual  intercourse  with  the  opposite  sex  is,  in 
itself,  possible.  At  any  rate,  in  cases  of  this  degree,  no  horror 
sexus  alterius  exists.     Here  is  a  fertile  field  for  the  application 


1  This  idea  is  supported  by  the  statements  of  an  unmarried  urning  which  Dr.  Moll, 
of  Berlin,  kindly  communicated  to  me.  He  could  report  a  number  of  cases  of  his  acquaint- 
ance, in  which  married  men  at  the  same  time  had  "  relations  "  with  men. 


232  PSYCHOPATHIA   SEXTJALIS. 

of  medical  and  moral  therapeutics  (v.  infra).  The  differential 
diagnosis  from  acquired  contrary  sexual  instinct  may  present 
difficulties;  for  in  such  cases,  as  long  as  the  vestiges  of  a 
normal  sexual  instinct  are  not  absolutely  lost,  the  actual  symp- 
toms are  the  same  (v.  infra).  In  the  first  degree,  the  sexual 
satisfaction  of  homo-sexual  impulses  consists  in  passive  and 
mutual  onanism  and  coitus  inter  femora. 

Case  106.  Psychical  Hermaphroditism  in  a  Lady. — Mrs.  M.,  aged 
44,  exemplifies  the  fact  that  an  inverted  and  a  normal  sexual  instinct 
may  be  united  in  one  person,  be  it  in  man  or  woman.  The  father  of  this 
lady  was  very  musical,  and  very  talented  as  an  artist.  He  took  life  easily  ; 
and  to  his  extraordinary  beauty  was  added  a  great  admiration  for  the 
opposite  sex.  After  several  apoplectic  attacks,  he  died  demented  in  an 
asylum.  Father's  brother  was  neuro-psychopathic,and  when  a  child  was  a 
somnambulist ;  and  all  his  life  he  was  afflicted  with  hyperesthesia  sexualis. 
Thus,  although  married  and  the  father  of  married  sons,  he  tried  to  seduce 
his  niece,  Mrs.  M.,  with  whom  he  was  wildly  in  love,  when  she  was 
eighteen  years  old.  Father's  father  was  very  eccentric  and  a  distin- 
guished actor.  He  first  studied  theology,  but,  as  a  result  of  partiality 
for  the  dramatic  muse,  he  became  an  actor  and  singer.  He  committed 
excesses  in  baccho  et  venere ;  was  a  spendthrift  and  luxurious.  He  died 
at  forty-nine,  of  apoplexia  cerebri.  Mother's  father  and  mother  died  of 
tuberculosis  of  the  lungs. 

Mrs.  M.  was  one  of  eleven  children,  of  whom  six  are  still  liv- 
ing. Two  brothers,  who  resembled  the  mother  physically,  died,  at  six- 
teen and  twenty,  of  tuberculosis.  A  brother  suffers  with  laryngeal 
phthisis.  Four  living  sisters  and  Mrs.  M.  resemble  the  father  physi- 
cally, and  the  eldest  is  unmarried,  very  nervous,  and  shy  of  people.  Two 
younger  sisters  are  married,  healthy,  and  have  healthy  children.  The 
other  is  unmarried,  and  suffers  with  nervous  complaints.  Mrs.  M.  has 
four  children,  several  of  whom  are  delicate  and  neuropathic. 

The  patient  can  tell  nothing  of  importance  concerning  her  child- 
hood. She  learned  easily,  and  was  aesthetically  and  poetically  inclined. 
She  was  considered  a  little  high-strung,  and  too  much  given  to  novel- 
reading  and  sentimentality.  Her  constitution  was  neuropathic,  and  she 
was  extremely  sensitive  to  changes  of  temperature,  sometimes  having 
annoying  cutis  anserina  as  a  result  of  slight  draughts.  It  is  remark- 
able that  one  day,  when  she  was  about  ten  years  old,  she  thought  that 
her  mother  no  longer  loved  her;  and  she  put  matches  in  her  coffee 
to  make  herself  really  sick,  that  she  might  thus  excite  her  mother's 
love  for  her. 

Puberty  began,  without  difficulty,  at  the  age  of  eleven.  Thereafter 
the  menses  were  regular.     Before  the  time  of  puberty  sexuality  mani- 


CONGENITAL   HOMOSEXUALITY.  233 

fested  itself,  and,  according  to  the  opinion  of  the  patient,  its  promptings 
have  been  abnormally  intense  all  her  life.  The  first  feelings  and  impulses 
were  decidedly  inverted.  She  conceived  a  passionate  but  platonic  love 
for  a  young  lady.  She  wrote  verses  and  sonnets  to  her,  and  was  per- 
fectly happy  if  she  could  admire  "  the  entrancing  charms  "  of  her  god- 
dess in  the  bath,  or  steal  a  glimpse  of  her  neck,  shoulders,  and 
breast  while  she  was  dressing.  The  wild  impulse  to  touch  these  physi- 
cal charms  was  always  overcome.  While  a  young  girl,  she  had  actually 
been  in  love  with  Madonnas  of  Raphael  and  Guido  Reni.  In  all  kinds 
of  weather  she  would  run  after  pretty  girls  and  ladies  for  hours  at  a 
time,  admiring  their  beauty,  losing  no  opportunity  to  please  them,  offer- 
ing them  bouquets,  etc.  The  patient' asserted  that,  until  the  age  of  nine- 
teen, she  was  absolutely  without  a  suspicion  of  a  difference  of  sex ; 
because  she  had  been  educated  as  in  a  cloister  by  a  very  prudish  aunt, 
who  was  an  old  maid.  As  a  result  of  this  great  ignorance,  the  patient 
became  the  victim  of  a  man  who  was  passionately  in  love  with  her,  and 
who  had  coitus  with  her  bjr  means  of  stratagem.  She  became  the  wife  of 
this  man,  bore  one  child,  and  lived  an  "  eccentric"  sexual  life  with  him. 
She  felt  perfectly  satisfied  with  married  intercourse.  After  a  few  years 
she  became  a  widow.  Since  then,  women  have  again  been  the  object  of 
her  love,  primarily,  as  the  patient  thinks,  from  fear  of  the  results  of 
sexual  intercourse  with  a  man. 

At  twenty-seven,  second  marriage,  without  love,  to  a  phthisical 
husband.  Patient  was  three  times  confined,  and  fulfilled  her  maternal 
duties.  Her  physical  health  failed,  and  in  the  later  years  of  this  mar- 
ried life  she  had  an  increasing  aversion  for  her  husband,  partly  due  to 
a  sense  of  his  disease,  though,  at  the  same  time,  there  was  constantly 
present  an  intense  desire  for  sexual  indulgence. 

Three  years  after  the  death  of  her  second  husband,  the  patient  dis- 
covered the  fact  that  her  nine-year-old  daughter,  by  her  first  husband, 
was  given  to  masturbation,  and  that  she  was  failing  in  physical  health. 
The  patient  read  of  this  vice,  and  could  not  overcome  the  impulse  to 
indulge  in  the  practice,  becoming,  in  consequence,  an  onanist.  She  is 
unable  to  bring  herself  to  give  the  details  of  this  period  of  her  life.  She 
says  that  she  was  frightfully  excited  sexually,  and  had  to  send  her 
daughters  from  home  to  save  them  from  terrible  consequences ;  but  the 
two  boys  she  was  able  to  keep  at  home. 

Patient  became  neurasthenic  ex  masturbatione  (spinal  irritation, 
feeling  of  pressure  in  head,  weariness,  lack  of  mental  control),  and,  at 
times,  had  dj'sthymia  and  painful  taedium  vitae.  Her  sexual  feeling 
would  be  directed  at  one  time  to  women,  at  another  to  men.  She  was 
able  to  restrain  herself,  and  suffered  much  from  abstinence,  especially 
because,  on  account  of  her  neurasthenic  troubles,  she  sought  to  obtain 
relief  in  masturbation,  though  only  in  case  of  great  necessity.  At  the 
present  time,  though  forty -four  years  old,  and  menstruating  regularly, 


234  PSYCHOPATHIA   SEXUALIS. 

she  suffers  intensely  with  a  passion  for  a  young  man  whose  presence  she 
cannot  avoid  on  account  of  the  exigencies  of  occupation. 

Patient  presents  nothing  remarkable  in  external  appearance.  She 
is  gracefully  formed,  but  the  muscular  system  is  not  strongly  developed. 
Pelvis  is,  in  all  respects,  that  of  a  female,  but  the  arms  and  legs  are  de- 
cidedly large  and  of  masculine  form.  Ladies'  shoes  do  not  fit  her,  but, 
being  opposed  to  exciting  attention,  she  forces  her  feet  into  female  shoes, 
and  they  are,  therefore,  much  deformed.  Genitals  normally  developed, 
and  present  no  other  abnormality  than  descent  of  the  uterus,  with  hyper- 
trophy of  the  vaginal  portion.  On  thorough  examination  it  is  seen  that 
the  patient  is  essentially  homo-sexual,  and  that  the  desire  for  the  oppo- 
site sex  is  but  episodical  and  sensual.  Thus,  at  present,  she  suffers 
intensely  with  sexual  desires  for  every  man  with  whom  she  comesin  con- 
tact, but  it  is  a  more  refined  and  higher  pleasure  for  her  to  imprint  a  kiss 
on  the  soft,  round  cheek  of  a  maiden.  This  pleasure  is  one  she  often 
enjoys,  because  she  is  much  beloved  as  the  "  dear  aunt "  by  all  the 
"  sweet  creatures " ;  for  she  voluntarily  does  them  the  most  various 
chivalrous  favors,  always  feeling  herself  at  such  times  as  a  man. 

Case  107.  Contrary  Sexual  Instinct  with  Sexual  Satisfaction  in 
Hetero-Sexual  Intercourse. — Mr.  Z.,aged  36,  Hollander,  consulted  me,  in 
1888,  on  account  of  an  anomaly  of  his  sexual  feelings,  which  had  become 
a  matter  of  anxiety  to  him  in  connection  with  an  intended  marriage. 
Patient's  father  was  neuropathic,  and  suffered  with  nightmare  and  night- 
terrors.  Grandfather  was  mentally  unsound  ;  father's  brother  an  idiot. 
Patient's  mother  and  her  family  were  healthy  and  normal  mentally.  The 
patient  had  four  sisters  and  one  brother,  the  latter  being  subject  to  moral 
insanity.     Three  sisters  are  healthy,  and  living  happy  married  lives. 

As  a  child,  the  patient  was  weak,  nervous,  and  subject  to  night-ter- 
rors, like  his  father ;  but  he  never  had  any  severe  sickness  except  coxitis, 
as  a  result  of  which  he  limps  slightly.  Sexual  impulses  were  manifested 
early.  At  eight,  without  any  teaching,  he  began  to  masturbate.  From 
his  fourteenth  j'ear,  ejaculation.  He  was  mentally  well  endowed,  and  his 
principal  interest  was  in  art  and  literature.  He  was  always  weak  muscu- 
larly,  and  had  no  inclination  for  bo}rish  sports  and  later  for  manly  occu- 
pations. He  had  a  certain  interest  for  female  toilettes,  ornaments,  and 
occupations.  From  the  time  of  puberty  the  patient  noticed  in  himself 
an  inexplicable  inclination  toward  male  persons.  Youths  of  the  lowest 
classes  were  especially  attractive  to  him.  Cavalrymen  especially  excited 
his  interest.  He  experienced  a  lustful  desire  to  press  himself  against 
such  individuals  from  behind.  Occasionally,  in  crowds,  it  was  possible 
for  him  to  do  this;  and  in  such  an  event  an  intense  feeling  of  pleasure 
passed  over  him.  After  his  twenty-second  37ear,  on  such  occasions,  he 
now  and  then  had  an  ejaculation.  From  that  time  ejaculation  occurred 
when  a  sympathetic  man  laid  his  hand  on  the  patient's  thigh.  He  was 
now  in  great  anxiety  lest  he  might  sometime  assault  a  man  sexually. 


CONGENITAL   HOMOSEXUALITY.  235 

People  of  the  lower  classes,  wearing  tight,  brown  trousers,  were  especially 
dangerous  for  him.  His  greatest  pleasure  would  be :  to  embrace  such  a 
man  and  press  himself  on  him  ;  but,  unfortunately,  the  morality  of  his 
country  did  not  allow  such  a  thing.    Pederasty  seemed  disgusting  to  him. 

It  gave  him  great  pleasure  to  gain  a  sight  of  the  genitals  of  males. 
He  was  always  compelled  to  look  at  the  genitals  of  every  man  he  met. 
In  circuses,  theatres,  etc.,  only  male  performers  interested  him.  Patient 
has  never  noticed  any  inclination  for  women.  He  does  not  avoid  them, 
even  dances  with  them  on  occasion,  but  he  never  feels  the  slightest 
sensual  excitation  under  such  circumstances. 

At  the  age  of  twenty-eight  the  patient  was  neurasthenic  as  a  result 
of  his  excessive  masturbation. 

Then  frequent  pollutions  in  sleep  occurred,  which  weakened  him 
very  much.  It  was  only  occasionally  that  he  dreamed  of  men  when  he  had 
pollutions  ;  and  never  of  women.  A  lascivious  dream-picture  (pederasty) 
had  occurred  but  once.  He  dreamed  of  dying-scenes,  of  being  attacked 
by  dogs,  etc.  After  these,  as  before,  he  suffered  with  great  libido  sexualis. 
Often  there  came  up  before  him  such  lascivious  thoughts  as  gloating  over 
the  death  of  animals  in  the  slaughter-house,  or  allowing  himself  to  be 
whipped  by  boys ;  but  he  always  overcame  such  desires,  and  also  the 
impulse  to  dress  in  a  military  uniform. 

In  order  to  cure  himself  of  masturbation,  and  to  thoroughly  satisfy 
his  libido,  he  determined  to  frequent  brothels.  He  first  attempted 
sexual  intercourse  with  a  woman  when  twenty -one,  after  over-indulgence  in 
wine.  The  beauty  of  the  female  form,  and  female  nudity  in  general,  made 
no  impression  on  him.  However,  he  was  able  to  enjoy  the  act  of  coitus, 
and  thereafter  he  visited  brothels  regularly  for  "  purposes  of  health." 

From  this  time  he  took  great  pleasure  in  hearing  men  tell  stories 
of  their  sexual  relations  with  the  opposite  sex. 

Ideas  of  flagellation  would  also  come  to  him  while  in  a  brothel,  but 
the  retention  of  such  fancies  was  not  essential  for  the  performance  of 
coitus.  He  considered  sexual  intercourse  with  prostitutes  only  a  remedy 
against  the  desire  for  masturbation  and  men, — a  kind  of  safety-valve  to 
prevent  compromising  himself  with  some  man. 

The  patient  now  wishes  to  marry,  but  fears  not  only  that  he  could 
have  no  love  for  a  decent  woman,  but  also  that  he  might  be  impotent  for 
intercourse  with  one.     Hence  his  thought  and  need  of  medical  advice. 

The  patient  is  very  intelligent,  and  is,  in  all  respects,  of  masculine 
appearance.  In  dress  and  manner  he  pi'esents  nothing  that  would  attract 
attention.  Gait,  voice, "and  skeleton, — the  pelvis  especially, — masculine 
in  character.  Genitals  of  normal  development.  The  normal  growth  of 
hair  for  a  male  is  abundant.  The  patient's  relatives  and  friends  have  not 
the  slightest  suspicion  of  his  sexual  anomalies.  In  his  inverted  sexual 
fancies,  he  has  never  felt  himself  in  the  role  of  a  woman  toward  a  man. 
For  some  years  he  has  been  entirely  free  from  neurasthenic  troubles. 


236  PSYCHOPATHIA   SEXTJALIS. 

The  question  as  to  whether  he  considered  himself  a  subject  of  con- 
genital inversion  of  sexual  instinct  he  could  not  answer.  It  seems  prob- 
able that  there  was  a  congenital  weak  inclination  for  the  opposite  sex, 
with  a  greater  one  for  the  same  sex,  which,  as  a  result  of  early  mastur- 
bation in  consequence  of  the  homo-sexual  instinct,  was  still  more  weak- 
ened, but  not  reduced  to  nil.  With  the  cessation  of  masturbation,  the 
feeling  for  women  became  in  a  measure  more  natural,  but  onby  in  a 
coarsely  sensual  way. 

Since  the  patient  explained  that,  for  reasons  of  family  and  business, 
it  was  necessar}'  for  him  to  marry,  it  was  impossible  to  avoid  this  delicate 
question. 

Fortunately,  the  patient  limited  his  inquiries  to  the  question  as  to 
his  virility  as  a  husband  ;  and  it  was  necessary  to  reply  that  he  was  virile, 
and  that  he  would  probably  be  so  in  conjugal  intercourse  with  the  wife 
of  his  choice, — at  least,  if  she  were  to  be  in  mental  sympathy  with  him  ; 
besides,  that  he  could  at  all  times  improve  his  power  by  exercising  his 
imagination  in  the  right  direction. 

The  main  thing  was  to  strengthen  the  sexual  inclination  for  the 
opposite  sex,  which  was  defective,  but  not  absolutely  wanting.  This 
could  be  done  by  avoiding  and  opposing  all  homo-sexual  feelings  and 
impulses,  possibly  with  the  help  of  the  artificial  inhibitory  influences  of 
h}'pnotic  suggestion  (removal  of  homo-sexual  desires  by  suggestion) ;  by 
the  excitation  and  exercise  of  normal  sexual  desires  and  impulses ;  by 
complete  abstinence  from  masturbation,  and  eradication  of  the  remnants 
of  the  neurasthenic  condition  of  the  nervous  system  by  means  of  hydro- 
therapy, and  possibly  general  faradization. 

I  am  indebted  to  a  physician,  aged  thirty,  for  the  following 
autobiography,  which  in  another  respect  is  noteworthy : — 

Case  108.  Mental  Hermaphroditism ;  Abortive  Contrary  Sexual 
Instinct. — "  In  my  ancestr}- 1  am  somewhat  predisposed  hereditarily.  My 
grandfather  on  my  father's  side  was  a  high-liver  and  a  speculator.  My 
father  was  a  man  of  character,  but  for  more  than  thirty  years  he  has 
suffered  with  folie  circulaire,  without,  however,  being  much  hindered  by 
it  in  business.  My  mother,  like  her  father  before  her,  suffers  with  steno- 
cardiac  attacks.  My  mother's  father  and  brother  are  said  to  have  been 
sexually  hyperaesthetic.  M%y  only  sister,  about  nine  years  older  than 
myself,  was  twice  subject  to  attacks  of  eclampsia,  and  during  puberty  was 
religiously  exalted,  and  probably  also  sexually  hyperaesthetic.  During 
man}'  years  she  had  to  suffer  with  a  severe  hvsterical  neurosis,  but  she  is 
now  completely  well. 

"  As  an  only  son,  and  born  late,  I  was  the  apple  of  my  mother's 
eye ;  and  I  have  her  indefatigable  care  to  thank  that  I  survived  childhood, 
after  having  passed  through  all  the  possible  diseases  of  children  (hydro- 


CONGENITAL   HOMOSEXUALITY.  237 

cephalus,  measles,  croup,  small-pox,  and,  at  thirteen,  chronic  intestinal 
catarrh  that  lasted  a  year).  My  mother,  being  herself  very  religious, 
raised  me,  without  spoiling  me,  in  a  religious  way,  and  implanted  in  me, 
as  the  guiding  moral  principle,  an  unyielding  devotion  to  duty,  which 
was  further  carried  to  an  extreme  in  me  by  a  teacher  whom  I  still  call  a 
friend.  Owing  to  my  delicate  health,  my  childhood,  in  greater  part, 
was  spent  in  bed ;  and  I  was  thus  given  to  quiet  occupations,  especially 
reading ;  and  thus  as  a  boy  I  came  to  be — if  not  blase — premature  at 
least.  As  early  as  eight  or  nine  the  parts  of  books  that  excited  me 
most  were  those  where  injuries  or  operations  that  had  to  be  endured 
by  beautiful  girls  or  ladies,  were  described.  Thus  I  was  thrown  into 
great  excitement  by  a  story  in  which  was  pictured  a  maiden  that  had 
run  a  thorn  into  her  foot,  with  a  boy  taking  it  out  for  her.  Indeed, 
every  time  that  I  looked  upon  this  picture,  which  was  in  nowise  las- 
civious, I  had  an  erection.  Whenever  possible,  I  went  to  see  chickens 
killed ;  and  if  I  had  missed  that,  I  looked  at  the  spots  of  blood,  and 
stroked  the  warm  bodies  of  the  birds,  with  pleasurable  shudders.  I 
would  emphasize  the  fact  that  I  have  always  been  a  great  lover  of  ani- 
mals, and  have  felt  disgust  and  pity  while  killing  larger  animals,  and 
even  in  the  vivisection  of  frogs. 

"  The  killing  of  chickens  is  still  a  great  sexual  stimulus  for  me,  and 
especially  holding  them,  during  which  I  have  palpitation  of  the  heart 
and  precordial  oppression.  It  is  of  interest  that  my  father  had  a  passion 
for  binding  together  the  hands  of  girls  and  young  women. 

"  I  think  that  another  of  my  sexual  abnormalities  is  attributable  to 
this  strain  of  cruelty.  As  I  shall  clearly  describe  later,  one  of  my  fa- 
vorite games  was  that  of  an  improvised  doll- theatre,  where  I  prescribed 
the  parts  of  my  companions.  Almost  always  it  was  a  young  girl  who, 
at  the  command  of  her  papa,  whom  I  represented,  had  to  have  a  painful 
operation  done  on  her  foot.  The  more  the  girl  cried,  the  more  satisfac- 
tion I  had.  How  I  came  to  hit  upon  the  foot  as  the  constant  object  of 
operation  will  be  seen  from  the  following :  When  a  very  young  boy,  I 
happened  to  see  my  eldest  sister  change  her  stockings.  When  she  hastily 
hid  her  feet,  my  attention  was  attracted,  and  immediately  the  sight  of  her 
bare  feet  to  the  ankles  came  to  be  the  ideal  of  my  longing.  Naturally, 
this  made  my  sister  very  careful ;  and  thus  there  was  occasioned  a  con- 
stant quarrel,  which,  on  my  part,  was  kept  up  with  all  the  wiles  of  cun- 
ning and  flattery,  and  with  even  explosions  of  anger,  until  my  seventeenth 
year.  In  other  respects  my  sister  was  very  indifferent.  Indeed,  her  kiss 
is  repugnant  to  me.  Faute  de  mieuxy  I  made  use  of  the  feet  of  ser- 
vants; masculine  feet  had  no  effect  on  me.  My  greatest  desire  would 
have  been  to  cut  the  nails,  or,  sit  venia  verbo,  the  corns,  on  the  beautiful 
foot  of  a  woman.  My  lustful  dreams  were  concerned  with  these  things. 
Indeed,  I  applied  myself  to  the  study  of  medicine  really  in  the  expec- 
tation of  gaining  an  opportunity  to  satisfy  my  desires,  or  cure  them. 


238  PSYCHOPATHIA   SEXUALIS. 

Thank  God,  I  attained  the  latter.  After  undertaking  the  first  dissection 
of  the  lower  extremity  of  a  female,  this  unhappy  desire  was  removed 
from  me.  I  was  unhappy  because  I  was  alwa3'S  deeply  ashamed  of  this 
impulse.  I  think  I  may  spare  further  details  concerning  it,  since  this 
peculiar  enthusiasm,  which  even  inspired  me  to  write  verses,  has  been 
sufficiently  described  by  others. 

"  Now,  concerning  the  last  phase  of  my  sexual  errors  :  I  was  about 
thirteen,  and  had  just  begun  to  mature,  when  a  school-mate,  who  hap- 
pened to  be  our  guest,  teased  me  one  night  by  kicking  me  with  his  bare 
feet  under  the  covers.  I  seized  his  foot,  and  immediately  became  greatly 
excited,  and  had  a  pollution  after  it, — the  first  that  I  had.  The  boy  was 
peculiarly  girlish  in  form,  and  was  also  mentally  effeminate.  Too,  another 
comrade  who  had  very  small  and  delicate  hands  and  feet,  whom  I  once 
saw  in  a  bath,  caused  unusual  excitement  in  me.  I  thought  it  a  great 
piece  of  good  fortune  to  be  in  bed  with  either  of  these,  though  any 
nearer  sexual  intercourse  than  embracing  them  never  came  into  my 
mind.  Moreover,  I  always  thrust  such  thoughts  aside  with  aversion. 
Some  years  later,  when  about  sixteen  or  eighteen,  I  made  the  acquaint- 
ance of  two  other  boys  that  awakened  my  sexual  feeling.  When  I  played 
with  either  of  these,  I  immediately  had  an  erection.  Both  were  very 
energetic  and  lively,  but  delicately  formed  and  child-like.  At  the  occur- 
rence of  puberty  I  lost  interest  in  both  of  them,  though  a  warm  friend- 
ship was  preserved.  I  should  never  have  allowed  myself  to  have  indulged 
in  vicious  practices  with  them. 

"  When  I  went  to  the  University,  I  forgot  completely  these  errors 
of  my  libido  sexualis,  and  from  principle  I  kept  from  sexual  intercourse 
until  I  was  twenty-four,  in  spite  of  the  contempt  of  my  companions. 
When  pollutions  became  too  frequent,  and  I  began  to  fear  cerebral  neu- 
rasthenia ex  abstinentia,  I  gave  myself  up  to  normal  sexual  indulgence, 
though  somewhat  mechanically ;  and  it  was,  of  course,  very  beneficial 
to  me. 

"  The  especial  field  of  work  to  which  I  have  devoted  myself  is  re- 
sponsible for  the  fact  that  I  am  almost  impotent  with  puellis  publicis, 
and  also  for  the  fact  that  the  naked  form  of  a  woman  disgusts  rather 
than  excites  me.  The  act  always  satisfies  me  the  most,  if,  during  it, 
I  can  keep  the  vision  of  the  face  before  me ;  but  since,  on  the  other 
hand,  the  idea  that  the  girl  near  me  is  enjoyed  by  another  is  unbearable, 
for  years  I  have  found  it  absolutely  necessary  for  my  mental  comfort, 
in  spite  of  the  pecuniary  sacrifice,  to  keep  a  mistress,  and,  indeed,  a 
virgin.  Otherwise  the  most  terrible  jealousy  made  me  absolutely  in- 
capable of  work.  I  must  also  mention  that,  at  thirteen,  I  fell  in  love 
platonically  for  the  first  time ;  and  since  then  I  have  often  pined  in 
chaste  love.  What  distinguishes  my  case  from  all  others  is  the  fact  that 
I  have  never  once  masturbated  in  my  life. 

"  Some  weeks  ago,  in  sleep,  I  was  frightened  by  a  dream  of  a  naked 


CONGENITAL   HOMO-SEXUALITY.  239 

boy,  from  which  I  awoke  with  an  erection.  In  conclusion,  I  venture  to 
undertake  the  difficult  task  of  describing  my  present  condition  :  Medium 
height,  gracefully  formed.  Skull  dolichocephalic,  with  prominence  in 
the  occipital  region ;  circumference,  59  centimetres  ;  frontal  prominence 
marked;  glance  somewhat  neuropathic;  pupils  medium ;  teeth  very  de- 
fective ;  musculature  strong  and  tense  ;  abundant  hair,  blonde.  Varicocele 
on  the  left  side ;  frenulum  too  short,  which  hindered  me  in  coitus.  I 
severed  it  myself  three  years  ago.  Since  then  ejaculation  is  retarded, 
and  pleasurable  feeling  much  diminished.  Temperament  choleric.  Quick 
of  comprehension ;  good  at  drawing  conclusions ;  energetic ;  for  one 
hereditarily  predisposed,  very  persevering.  I  learn  languages  easily, 
and  have  a  good  ear  for  music,  but  otherwise  I  have  no  talent  for  the  arts. 
I  am  always  ambitious  to  do  my  duty,  but  I  am  constantly  troubled  with 
toed i urn  vitoe,  and  only  kept  from  attempts  at  suicide  by  my  religion  and 
the  thought  of  my  mother.  Otherwise  I  am  a  typical  candidate  for 
suicide.  I  am  ambitious,  jealous,  have  a  fear  of  paralysis  ;  left-handed. 
I  am  filled  with  socialistic  ideas.  I  like  adventures,  and  I  am  courageous. 
I  have  decided  never  to  marry." 

Case  109.  Psychical  Hermaphroditism.  Autobiography. — "  I  was 
born  in  1868.  The  families  of  both  my  parents  are  healthy  ;  at  any  rate, 
mental  disease  has  never  occurred  in  them.  My  father  was  a  merchant ; 
he  is  now  sixty-five  years  old,  and  for  j'ears  has  been  nervous  and  espe- 
cially inclined  to  be  melancholic.  Before  his  marriage,  my  father  is  said 
to  have  lived  fast.  My  mother  is  healthy,  though  not  very  strong. 
There  are  two  other  healthy  children. 

"  I  was  very  early  developed  sexually,  and  in  my  fourteenth  year 
was  so  much  troubled  by^  pollutions  that  I  was  frightened.  Under  what 
circumstances  they  occurred,  particularly  the  nature  of  the  dreams  that 
were  connected  with  them,  I  am  no  longer  able  to  st:ite.  The  fact  is, 
that  for  years  I  have  only  felt  myself  drawn  toward  men  sexually  ;  and, 
with  every  effort  and  a  terrible  struggle,  I  am  still  unable  to  overcome 
this  unnatural  impulse  that  is  so  repugnant  to  me.  It  is  said  that  I  had 
many  severe  illnesses  in  my  childhood,  and  that  my  life  was  often  de- 
spaired of.  To  this  was  probably  due  the  fact  that  I  was  spoiled  and 
made  very  delicate.  I  was  always  much  in  the  house,  preferred  to  play 
with  dolls  rather  than  with  soldiers,  and  I  liked  to  play  quietly  in  the 
house  better  than  to  play  noisily  in  the  streets.  I  entered  the  Gymna- 
sium at  the  age  of  ten.  Though  I  was  lazy,  I  was  among  the  best 
scholars ;  for  I  learned  very  easily,  and  was  the  favorite  of  my  teacher. 
From  my  earliest  childhood  (seventh  year),  I  took  pleasure  in  little 
girls.  I  remember  that,  even  until  my  thirteenth  year,  I  had  formal  love- 
affairs  with  them,  and  was  jealous  of  those  who  associated  with  them ; 
that  I  took  pleasure  in  looking  under  the  petticoats  of  my  sister's  friends 
and  the  servants ;  and  that  I  had  erections  when  touching  the  persons 
of  my  female  playmates.     I  can,  however,  recall  with  certainty  that  boys 


240  PSYCHOPATHIA   SEXUAUS. 

attracted  and  excited  me  sexually  just  as  early  and  powerfully.  I  always 
took  great  delight  in  reading  and  in  the  theatre.  I  had  a  doll-theatre, 
with  which  I  played  by  preference.  I  knew  whole  pieces  by  heart,  and 
copied  the  actors  I  saw,  taking  especially  the  female  parts,  in  which  I 
was  delighted  to  put  on  female  attire. 

"  As  my  sexual  life  became  more  pronounced,  my  inclination  for 
boj's  won  the  upper  hand.  I  fell  completely  in  love  with  my  compan- 
ions, and  had  lustful  feeling  if  one  of  them  who  pleased  me  touched  my 
body.  I  became  very  shy,  and  refused  to  take  gymnastic  and  swimming 
lessons.  I  thought  I  was  different  from  my  comrades,  and  did  not  like 
to  undress  before  them.  I  liked  to  look  at  the  penes  of  my  companions, 
and  easily  had  erections.  I  masturbated  but  once,  and  that  in  my  youth. 
When  a  friend  told  me  that  one  could  have  pleasure  without  women,  I 
likewise  tried  it ;  but  I  found  no  pleasure  in  it.  At  that  time,  also,  a 
book  fell  in  my  hands  which  warned  against  the  effects  of  onanism. 
After  that  one  trial  I  never  did  it  again.  In  my  fourteenth  or  fifteenth 
year,  I  made  the  acquaintance  of  two  younger  boys  who  excited  me  sex- 
ually to  the  highest  degree.  I  was  especially  in  love  with  one  of  them. 
I  became  sexually  excited  in  his  presence,  and  was  restless  when  I  did 
not  have  him  near  me.  I  was  jealous  of  those  who  associated  with  him, 
and  embarrassed  in  his  presence.  He  had  no  suspicion  of  my  condition. 
I  felt  very  unhappy,  and  often  wept  gladly,  feeling  then  relieved.  Yet  I 
could  not  understand  this  feeling,  and  always  felt  its  irregularity.  I  was 
also  especially  unhappy  because  my  ability  to  work  disappeared  all  at 
once.  I,  who  before  had  learned  with  ease,  suddenly  had  difficulty ; 
my  thoughts  were  never  on  the  subject.  Only  by  straining  every  nerve 
could  I  get  anything  through  my  head.  I  always  had  to  study  aloud,  in 
order  to  keep  my  attention  on  the  matter  in  hand.  My  memory,  which 
was  previously  excellent,  often  left  me  in  the  lurch.  Nevertheless,  I 
continued  to  be  a  good  scholar,  and  I  still  pass  for  a  talented  man  ;  but 
I  have  terrible  difficulty  in  learning  anything.  I  exerted  all  my  energy 
to  free  myself  from  this  sad  condition.  Daily  I  went  swimming ;  I 
practiced  turning,  rode  much,  and  practiced  fencing,  in  all  of  which  I 
enjoyed  myself  very  much.  I  still  like  to  be  on  a  horse's  back,  though  I 
know  nothing  about  horses,  and  have  no  particular  talent  for  physical 
exercises.  I  was  never  absent  from  a  drinking-party,  and  I  smoked.  I 
was  much  liked.  In  cafes  I  associated  much  with  waitresses,  and  liked 
to  amuse  myself  with  them,  without,  however,  being  sexually  excited  by 
them.  Among  my  friends  and  teachers,  I  passed  for  a  man  who  was 
much  with  women,  and  spoiled  by  them.  Unfortunately,  this  was  not 
true. 

"  At  the  age  of  nineteen  I  went  to  the  Universit}r.  My  first  semester 
was  spent  at  the  University  of  B.,  and  it  is  still  terrible  to  recall  it. 
M}r  sexual  appetite  powerfully  excited  me,  and  at  night,  for  hours  at  a 
time,  I  ran  about  looking  for  men,  especially  when  I  was  intoxicated. 


CONGENITAL  HOMO-SEXUALITY.  241 

The  next  morning  I  would  be  crazy  about  myself.  Fortunately,  I  found 
no  one.  In  the  second  semester,  I  went,  to  M.  This  was  my  happiest 
time.  I  had  pleasant  friends,  and,  for  a  wonder,  took  pleasure  in  women, 
and  was  very  happy  about  it.  I  had  a  love-affair  with  a  young  girl  of 
spoiled  character,  with  whom  I  spent  wild  nights.  I  was  extraordinarily 
virile.  I,  who  had  formerly  been  chaste,  also  associated  with  other 
women,  as  never  before.  I  felt  fresh  and  well  after  coitus.  I  was  not 
charmed  so  much  by  the  female  figure,  which  was  never  beautiful  to  me, 
as  b}r — I  know  not  what.  In  short,  I  knew  women  whose  touch  imme- 
diately induced  erection.  This  joy  and  state  of  delight  did  not  last 
long.  I  was  so  foolish  as  to  take  rooms  with  a  friend.  We  had  one 
sleeping-room.  My  friend  was  very  talented  and  amiable,  and  a  favorite 
with  women  ;  and  it  was  by  these  characteristics  that  he  at  first  so 
strorigly  attracted  me.  In  fact,  I  love  only  highly-educated  men  ;  unedu- 
cated, powerful  persons  are  able  to  excite  me  intensely  only  for  the 
moment,  and  cannot  retain  my  affections.  I  soon  fell  in  love  with  my 
friend.  Then  came  the  terrible  time  that  destroyed  my  health.  I  slept 
in  the  same  room  with  my  friend,  and  had  to  see  him  undress  daily ;  so 
that  it  required  all  my  strength  to  keep  from  betraying  myself.  I  be- 
came nervous,  cried  easily,  and  was  jealous  of  those  who  associated  with 
my  friend.  I  still  associated  with  women  ;  but  it  was  only  with  difficulty 
that  I  could  perform  coitus,  which,  like  woman,  was  repugnant  to  me. 
The  same  women  who  had  excited  me  intensely,  no  longer  had  any  effect 
on  me.  I  followed  my  friend  to  W.,  where  he  met  an  earlier  friend, 
with  whom  he  associated.  I  became  jealous  and  sick  with  love  and 
longing.  At  the  same  time,  I  associated  with  women  again,  but  seldom, 
and  only  with  difficulty,  indulged  in  coitus.  I  became  terribly  depressed 
and  almost  insane.  Work  was  out  of  the  question.  I  led  a  foolish, 
wild  life,  and  spent  a  great  amount  of  money,  almost  throwing  it  away. 
Then,  after  six  weeks  of  it,  I  broke  down,  and  had  to  visit  a  water-cure, 
where  I  spent  man}'  months.  There  I  came  to  myself  again,  and  soon 
became  much  liked ;  for  I  can  be  very  gay,  and  I  take  great  pleasure  in 
the  society  of  educated  ladies.  In  conversation,  I  prefer  married  women 
to  j^ounger  girls ;  I  am  also  very  gay  in  the  society  of  gentlemen  at  the 
beer-table  and  bowling-alley. 

"  At  this  sanitarium  I  met  a  man  of  twenty-nine,  who  was  appar- 
ently constituted  like  myself.  The  fellow  forced  himself  upon  me,  and 
wanted  to  embrace  and  kiss  me  ;  but  he  was  very  repugnant  to  me,  though 
he  excited  me,  and  his  touch  caused  erection,  and  even  ejaculation.  One 
evening  he  got  me  to  perform  mutual  onanism.  After  it  I  spent  a  most 
frightful,  sleepless  night ;  I  was  terribly  disgusted  with  the  whole  affair, 
and  thought  I  should  never  do  such  a  thing  with  a  man  again.  All  day 
long  I  could  get  no  rest.  It  was  terrible  to  me  that,  in  spite  of  this,  and 
against  my  will,  this  man  so  excited  me  sexually ;  yet,  on  the  other  hand, 
it  gave  me  satisfaction  that  he  was  in  love  with  me,  and  apparently  had 

1G 


242  PSYCHOPATHIA    SEXUALIS. 

to  go  through  struggles  similar  to  my  earlier  ones.  From  that  time  I 
was  successful  in  keeping  him  away  from  me. 

"  I  again  went  to  various  Universities,  and  also  visited  many  water- 
cures,  with  temporary,  but  never  permanent,  benefit.  I  fell  in  love,  too, 
with  many  friends,  but  never  so  deeply  as  with  the  friend  at  M.  I  no 
longer  had  sexual  intercourse,  neither  with  women — I  was  incapable  of 
it — nor  with  men ;  for  I  had  no  opportunity  for  it  with  the  latter,  and  I 
forced  myself  to  avoid  it.  I  still  often  met  my  friend  of  M. ;  we  are  as 
good  friends  as  ever,  and,  much  to  my  delight,  he  no  longer  excites  me. 
It  is  usually  so ;  when  for  a  long  time  I  have  not  seen  a  person  who 
excites  me,  the  sexual  influence  disappears. 

"  I  passed  my  examinations  with  distinction.  During  the  last  year 
before  they  took  place, — when  I  was  twenty-three, — I  began  to  practice 
masturbation;  for  I  could  find  no  other  way  in  which  to  gratify  my 
burdensome  sexual  appetite.  Still,  I  did  it  very  infrequently ;  for  after 
it  I  was  always  disgusted,  and  spent  a  sleepless  night.  But  when  I 
have  drunk  much,  I  lose  all  strength ;  and  then  I  run  about  for  hours, 
seeking  men,  and  finally  come  to  onanism,  to  awake  the  next  day  with  a 
dull  head  and  a  horror  of  myself,  and  go  about  all  day  in  a  melancholy 
state.  As  long  as  I  have  control  of  myself,  I  use  all  my  strength  to 
combat  my  nature.  It  is  terrible  when  one  can  have  no  pleasure  in  asso- 
ciating with  friends,  and  every  erect  soldier  or  butcher-boy  makes  one 
tremble  and  throb.  It  is  frightful  when  night  comes,  and  I  watch  at 
the  window  for  some  one  to  urinate  against  a  wall  across  the  way,  and 
give  me  an  opportunity  to  see  his  genitals.  These  thoughts  are  terrible ; 
and  besides,  there  is  the  consciousness  of  the  immorality  and  criminality 
of  my  state  of  mind  and  my  longing.  I  have  a  repugnance  for  myself  that 
I  cannot  describe.  I  consider  my  condition  abnormal ;  I  cannot  think  that 
it  is  congenital,  but  I  believe  that  the  impulse  was  bred  in  me  by  faulty 
education.  My  suffering  makes  me  reckless  and  egotistical ;  it  takes 
away  all  kindness  of  disposition,  and  makes  me  careless  about  my  family. 
I  am  moody,  and  often  almost  insane ;  often  I  am  so  depressed  that  I 
know  not  what  to  do,  and  then  am  easily  moved  to  tears.  And  yet  I  have  a 
horror  of  sexual  intercourse  with  men.  One  evening  when  I  came  from 
a  drinking-party,  drunk  and  excited  and  in  a  half-conscious  state,  and, 
full  of  desire,  was  wandering  about,  I  met  a  young  man,  who  got  me  to 
perform  mutual  masturbation.  Though  he  excited  me,  after  the  act  I  was 
beside  myself.  To-day,  when  I  go  by  the  place,  I  am  overcome  with 
horror ;  and  lately,  when  riding  by  it,  without  any  cause,  I  fell  from  my 
gentle  horse,  that  I  know  so  well, — I  was  so  overcome  by  the  memory 
of  my  unworthy  deed. 

"  I  love  family  life  and  children,  and  social  intercourse  ;  and,  with 
my  position  in  society,  I  am  suited  to  have  a  family.  But  I  must  give 
up  all  that ;  and  yet,  I  cannot  abandon  hope  of  cure.  And  so  I  vacillate 
between  hopeful  gaiety  and  frightful  hopelessness,  and  neglect  business 


CONGENITAL   HOMOSEXUALITY.  243 

and  family.  Indeed,  I  do  not  ask  that  I  may  marry  and  found  a  family ; 
I  wish  only  to  overcome  the  terrible  inclination  for  the  male  sex ;  only 
to  associate  quietly  with  my  friends,  and  to  learn  to  respect  myself  again. 

"  No  one  has  any  suspicion  of  my  condition  ;  I  pass  rather  for  a 
great  roue, — a  reputation  I  try  to  maintain.  I  often  try  to  have  relations 
with  girls,  for  which  I  often  have  opportunity.  I  have  known  many  who 
loved  me,  and  who  would  have  sacrificed  their  honor  for  me ;  but  I  have 
no  love  to  offer  them,  and  nothing  sexual  to  give.  And  j^et  I  can  love  a 
man.  I  am  excited  only  by  young  men, — i.e.,  aged  from  seventeen  to 
twenty-five,  without  full  beards,  and  preferably  with  no  beards  at  all.  I 
can  love  only  those  that  are  educated,  respectable,  and  amiable.  I  am,  in 
short,  very  proud,  and  quick;  I  am  also  enthusiastic,  and  easily  led  by 
persons  who  please  me.  These  I  try  to  imitate,  but  I  am  very  sensitive 
with  them,  and  easily  hurt.  I  put  much  value  on  appearances,  love 
beautiful  furniture  and  dress,  and  assume  a  distinguished  manner  and 
elegant  address.  I  am  unhappy  in  that  my  neurasthenic  condition  keeps 
me  from  doing  and  learning  what  I  should  like." 

Last  fall  I  made  the  patient's  acquaintance.  He  is  destitute  of 
degenerative  signs,  and  of  perfectly  masculine  appearance,  even  though 
he  is  delicately  formed  and  slender.  Genitals  perfectly  normal.  Appear- 
ance distinguished,  with  nothing  striking.  He  is  much  troubled  about 
his  sexual  perversion,  and  wishes  to  be  freed  from  it  at  any  price.  In 
spite  of  the  greatest  effort  on  the  part  of  both  physician  and  patient, 
only  a  slight  degree  of  hypnosis,  insufficient  for  suggestive  treatment, 
could  be  induced. 

Case  110.  Psychical  Hermaphroditism — Mouth-fetichism. — "I  am 
thirty-one  years  old,  and  an  official  in  a  manufactory.  My  parents  are 
healthy,  and  have  nothing  abnormal  about  them.  My  paternal  grand- 
father is  said  to  have  had  brain  disease;  my  maternal  grandmother 
died  melancholic;  a  cousin  of  my  mother  was  given  to  drink;  several 
other  blood-relations  are  abnormal  mentally. 

"  I  was  four  years  old  when  my  sexual  appetite  awoke.  A  man 
between  twenty  and  thirty  years  old,  who  played  with  us  children,  and 
took  us  in  his  arms,  excited  in  me  the  desire  to  embrace  and  kiss  him 
passionately.  This  desire  for  sensual  kissing  on  the  mouth  is  character- 
istic of  me,  and  it  still  forms  the  chief  charm  of  my  sexual  gratification. 

"  I  experienced  a  similar  excitation  in  about  my  ninth  year.  A 
man  who  was  ugly  and  dirty,  and  had  a  red  beard,  likewise  excited  in 
me  this  desire  for  him.  Here  was  manifested,  for  the  first  time,  a  char- 
acteristic peculiar  to  me,  which  is  still  present, — i.e.,  the  peculiar 
stimulus  which  coarseness — the  filthiness  of  a  person  in  dress  and  con- 
duct— is  to  my  senses  at  times. 

"  While  in  the  Gymnasium,  from  my  eleventh  to  my  fifteenth  year, 
I  was  affected  with  a  passion  for  a  comrade.  In  this  case,  it  was  also  my 
greatest  pleasure  to  embrace  him,  and  kiss  him  on  the  mouth.     I  was 


244  PSYCHOPATHIA   SEXUALIS. 

often  seized  with  a  desire  for  him  as  intense  as  that  I  now  have  for  per- 
sons I  love.  I  think,  however,  that  I  first  had  erections  in  my  thirteenth 
year.  During  these  jrears,  as  I  have  said,  I  had  only  the  desire  to 
embrace  and  kiss;  cupiditas  videndi  vel  tangendi  aliorum  genitalia  mihi 
plane  deerat.  I  was  a  perfectly  innocent,  naive  boy,  and,  until  my  fif- 
teenth year,  did  not  know  the  meaning  of  an  erection ;  indeed,  I  never 
once  ventured  to  kiss  the  beloved  person ;  for  I  felt  that  it  would  be 
doing  something  strange.  I  felt  no  desire  to  masturbate,  and  also  had 
the  good  fortune  not  to  be  seduced  to  it  by  older  comrades.  I  have 
never  yet  masturbated  ;  I  feel  a  certain  repugnance  for  it. 

"  In  my  fourteenth  and  fifteenth  years  I  was  seized  with  a  passion 
for  several  young  persons,  some  of  whom  still  attract  me.  Thus  I  was 
very  much  in  love  with  a  boy  with  whom  I  had  never  spoken.  It  was 
even  a  delight  to  meet  him  on  the  street. 

"  That  my  passions  were  of  a  sensual  nature  is  shown  by  the  fact 
that,  when  I  pressed  and  caressed  the  hands  of  those  I  loved,  I  had  pow- 
erful erections.  But  it  has  always  been  my  greatest  pleasure  amplecti 
et  os  osculari ;  I  desired  nothing  else. 

"  I  did  not  know  that  what  I  experienced  was  sexual  love ;  I  only 
said  to  myself  that  it  was  impossible  that  I  alone  felt  such  stimuli. 

"  Until  my  fifteenth  year  a  woman  had  never  excited  me ;  but  one 
evening*  when  I  was  alone  with  our  servant-girl  in  a  room,  I  experienced 
the  same  desire  that  I  had  for  many  boys.  At  first  I  played  with  her ; 
and,  when  I  found  that  she  liked  to  be  kissed,  I  covered  her  with  kisses. 
I  felt  such  sensual  pleasure  in  it  as  I  now  seldom  experience.  Mouth  to 
mouth,  we  kissed  each  other,  and  after  about  ten  minutes  ejaculation 
occurred.  Thus  I  gratified  myself  two  or  three  times  a  week.  I  soon 
began  a  similar  relation  with  our  cook,  and  with  other  servant-girls. 
Ejaculation  always  took  place  after  kissing  for  about  ten  minutes. 

"  In  the  meantime,  I  had  taken  dancing-lessons.  There  I  was  first 
charmed  by  a  nice  girl ;  but  this  love  soon  disappeared,  and  I  fell  in 
love  with  another  girl,  with  whom  I  never  became  acquainted,  but  at 
the  sight  of  whom  I  felt  an  attraction  like  that  of  boys,  and  unlike  the 
purely  brutal  passion  I  felt  for  other  girls.  At  this  time  my  impulse 
for  girls  was  at  its  acme ;  I  was  pleased  by  about  an  equal  number  of 
girls  and  boys.  As  mentioned  above,  I  gratified  my  sensuality  by  kiss- 
ing the  servant-girl  and  inducing  ejaculation.  Thus  I  spent  the  time 
from  my  sixteenth  to  my  eighteenth  year.  The  departure  of  the  servant 
deprived  me  of  opportunity. 

"Then  came  two  or  three  years  during  which  I  had  to  give  up 
sexual  pleasure.  In  general,  girls  pleased  me  less;  and,  too,  now  that  I 
had  grown  older,  I  was  ashamed  to  surrender  myself  to  the  servant-girls. 

"  It  was  not  possible  for  me  to  obtain  a  mistress ;  for,  notwith- 
standing my  years,  I  was  carefully  watched  by  my  parents,  and  asso- 
ciated but  little  with  young  men,  and  thus  had  but  little  independence. 


CONGENITAL  HOMO-SEXUALITY.  245 

With  the  diminution  in  the  desire  for  women,  the  attractiveness  of  youths 
increased. 

"  Since  I  had  had,  since  my  sixteenth  year,  frequent  pollutions  at 
night  with  dreams, — in  part  of  women  and  in  part  of  men, — which  weak- 
ened and  depressed  me  exceedingly,  I  desired  to  make  an  end  of  them 
by  means  of  normal  coitus.  But  scruples  and  the  belief  that  prostitutes 
would  have  no  effect  on  me,  kept  me  from  the  brothel  until  my  twenty- 
first  year.  For  two  or  three  years  I  went  through  a  daily  struggle  (if 
there  had  been  male  houses  of  prostitution,  no  scruples  would  have 
hindered  me).  Finally  I  visited  a  brothel.  I  could  not  even  induce 
erection  ;  for  one  reason  because  the  girl,  though  she  was  unusually 
fresh  and  pretty  for  a  prostitute,  did  not  affect  me;  but  really  because 
she  would  not  kiss  me  on  the  mouth.  I  was  very  much  depressed,  and 
thought  I  was  impotent.  Three  weeks  afterward  I  visited  another  pros- 
titute, and  she  immediately  induced  erection  by  her  kiss.  She  was 
erect  and  had  thick  lips,  and  was  much  more  sensual  than  the  first 
one.  After  only  three  minutes  of  simple  kissing,  mouth  to  mouth,  ejac- 
ulation was  induced, — of  course,  ante  portam.  Thus  it  was  only  after  I 
had  visited  prostitutes  about  seven  times  that  I  was  successful  in  coitus. 

"  At  one  time  I  would  have  no  erection  at  all,  because  the  girl  made 
no  impression  on  me ;  again  I  would  ejaculate  prematurely.  The  first 
times  I  was  reluctant  penem  introducere  ;  and,  too,  even  after  I  was  suc- 
cessful in  normal  coitus,  I  found  no  pleasure  in  it.  Sensual  satisfac- 
tion comes  with  kissing  on  the  mouth ;  for  me  this  is  the  principal 
thing,  coitus  serving  only  as  something  secondary  to  embracing. 
Coitus,  no  matter  how  much  the  woman  might  charm  me,  would  be 
an  indifferent  matter  without  kissing;  indeed,  erection  disappears,  or 
does  not  occur  at  alf^when  the  woman  will  not  kiss  on  the  mouth.  Yet, 
I  cannot  kiss  every  woman,  but  only  such  as  have  faces  pleasing  to  me  ; 
a  prostitute,  the  sight  of  whom  is  repugnant  to  me,  with  any  amount  of 
kissing,  which  then  only  disgusts  me,  cannot  excite  me. 

"  Thus,  during  the  last  four  years,  I  have  visited  brothels  about 
every  ten  days  or  two  weeks.  Only  seldom  does  coitus  fail ;  for  I  have 
learned  my  peculiarities,  and  in  the  choice  of  a  prostitute  know  imme- 
diately whether  she  will  excite  me  or  have  no  effect.  Of  late,  however, 
it  has  again  happened  that  I  thought  the  woman  would  stimulate  me,  and 
yet  no  erection  occurred.  This  happened  when,  the  day  before,  I  had  to 
repress  too  forcibly  the  desire  for  men. 

"At  first,  when  I  went  to  brothels,  the  sensual  pleasure  was  very 
slight;  only  a  very  few  times  did  I  have  true  lustful  feeling  (as  in  kiss- 
ing previously).  Now,  on  the  contraiy,  for  the  most  part  I  experience 
sensual  pleasure.  The  lower  houses  have  a  particular  charm  for  me ; 
for  of  late  the  coarseness  of  the  women,  the  dark  entrance,  the  yellow 
light  of  the  lamps,  and  all  the  surroundings,  have  a  peculiar  charm  for 
me ;  probably  because  my  sensuality  is  unconsciously  excited  by  meet- 


246  tSYCHOPATHIA   SEXUALlS. 

ing  soldiers,  who  frequent  such  places,  and  who  at  the  same  time  lend  a 
certain  charm  to  the  women.  If  I  but  find  a  Woman  whose  face  attracts 
me,  I  can  have  intense  lustful  pleasure.  Besides  by  prostitutes,  my  de- 
sire can  be  excited  by  peasant-girls,  servant-girls,  working-women,  and 
girls  of  the  lower  classes, — in  general,  by  those  in  common  dress.  Red 
cheeks,  thick  lips,  and  erect  forms  please  me  particularly.  lam  abso- 
lutely indifferent  to  respectable  women  and  young  ladies. 

"  My  pollutions  are  usually  without  lustful  pleasure,  and  often  occur 
with  dreams  of  men,  but  very  seldom — almost  never — with  dreams  of 
women.  As  is  shown  by  the  last  circumstance,  in  spite  of  regular  coitus, 
my  desire  is  still  for  young  men.  Indeed,  I  may  say  that  it  has  only  in- 
creased, and  that  very  markedly.  Though  immediately  after  coitus 
the  girls  have  no  charm  for  me,  yet  the  kiss  of  a  pleasing  woman  could 
immediately  induce  erection  again.  For  the  first  few  days  after  coitus, 
young  men  seem  the  most  attractive  to  me. 

"  Sexual  congress  with  women  does  not  satisfy  all  my  sensual  desire. 
I  have  days  when  I  frequently  have  erections  with  an  intense  desire  for 
young  men  ;  then  come  quieter  days,  with  moments  of  complete  indiffer- 
ence for  women  and  latent  desire  for  men.  On  the  other  hand,  too  great 
sensual  rest  makes  me  melancholy  ;  viz.,  when  such  rest  follows  moments 
of  repressed  excitement.  Only,  then,  when  the  thought  of  beloved 
j'ouths  again  causes  erection,  do  I  feel  light-hearted  again.  Then  the 
rest  changes  to  intense  nervousness  ;  I  feel  depressed,  and  sometimes 
have  headache  (after  repressed  erection).  This  nervousness  often  in- 
creases to  ungovernable  restlessness,  which  I  then  seek  to  overcome  by 
coitus. 

"  Last  year  an  essential  change  took  place  in  my  sexual  life,  when 
I  dared  to  enjoy  male  love  for  the  first  time.  In  spite  of  pleasurable 
coitus  with  women  (more  correctly,  pleasurable  kissing  with  resultant 
ejaculation),  my  desire  for  young  men  gave  me  no  peace.  I  determined 
to  go  to  a  brothel  much  frequented  by  soldiers,  and,  in  extremity,  to 
buy  a  soldier  for  mj'self.  I  had  the  good  luck  to  meet  immediately  one 
like  ni}'self,  who,  notwithstanding  his  much  lower  station,  in  diameter 
and  behavior  was  not  unworthy  of  me.  What  I  experienced  (and  still 
experience)  with  this  young  man  is  something  different  from  what  I  feel 
with  Avomen.  The  sensual  pleasure  is  not  greater  than  with  prostitutes, 
whose  kisses  and  embraces  excite  me  extraordinarily ;  but  I  can  experi- 
ence lustful  pleasure  with  him  at  any  time,  and  for  him  I  have  a  feeling 
that  is  wanting  for  women.  Unfortunately,  I  have  been  able  to  embrace 
and  kiss  him  only  about  eight  times. 

"  Though  we  have  been  separated  many  months,  he  having  been 
sent  to  a  garrison  in  Hungary,  we  have  not  forgotten  each  other,  and 
keep  up  a  regular  correspondence.  In  order  to  possess  him,  I  dared  to 
go  to  a  brothel  and  there  embrace  him,  being  in  danger  of  being 
betrayed. 


CONGENITAL   HOMOSEXUALITY.  247 

u  Early  in  our  acquaintance  there  came  a  time  when  I  heard 
nothing  more  of  him  ;  for  he  did  not  think  he  could  trust  me.  During 
these  weeks  I  endured  anxiety  and  pain  that  brought  me  into  a  state  of 
depression  and  anxious  restlessness,  such  as  I  had  never  before  expe- 
rienced. Scarcely  to  have  found  a  lover  and  then  to  be  compelled  to 
lose  him,  seemed  the  greatest  misfortune  to  me.  When,  thanks  to  my 
efforts,  we  met  again,  my  joy  was  unbounded;  indeed,  I  was  so  excited 
that,  in  his  embrace  again  for  the  first  time,  in  spite  of  my  sensual  lust, 
I  could  not  induce  ejaculation. 

"  Usus  sexualis  in  osculis  et  amplexionibus  solis  constitit,  pene 
meo  ludere  ei  licebat  (while  the  touch  on  it  of  a  woman's  hand  is  unen- 
durable to  me,  and  I  never  allow  it).  It  is  also  to  be  noted  that,  in  the 
company  of  my  lover,  I  immediately  have  an  erection ;  the  pressure  of 
his  hand,  or  even  his  look,  is  sufficient.  Evenings,  for  hours  at  a  time, 
I  have  gone  about  with  him,  never  tiring  of  his  society  for  a  moment, 
despite  his  inferior  station.  With  him  I  feel  happy,  and  the  sexual 
satisfaction  is  merely  the  crowning  of  our  love.  Although  I  had  finally 
found  the  man  like  nryself,  whom  I  had  so  long  sought,  and  I  could  at 
last  enjoy  male  love,  yet  I  have  not  become  insensitive  to  women ;  and  I 
visit  brothels  when  I  am  too  sorely  troubled  by  desire.  I  had  hoped  to 
be  able  to  spend  this  winter  in  the  city  where  my  lover  is  ;  but  this'  is, 
unfortunately,  impossible,  and  I  am  now  forced  to  be  separated  from 
him  for  an  indefinite  period.  Nevertheless,  we  shall  try  to  see  each 
other,  if  only  for  a  short  time,  and  onby  once  or  twice  a  year;  at  least,  I 
hope  that  in  the  future  we  may  again  be  together  for  a  longer  time. 
Thus,  for  this  winter,  I  am  again  compelled  to  be  without  a  friend  like 
myself.  I  had,  indeed,  resolved,  on  account  of  the  danger  of  discovery, 
never  to  try  to  find  another  urning ;  but  this  is  impossible.  Sexual 
intercourse  with  women  does  not  satisfy  me,  and  my  desire  for  young 
men  constanthy  increases.  I  am  often  afraid  of  nryself ;  afraid  that,  in 
asking  all  prostitutes,  as  I  do,  whether  thej'  know  others  like  me,  I 
might  be  discovered.  Yet  I  cannot  keep  from  seeking  a  youth  like 
myself;  indeed,  I  know  that  in  case  of  necessity  I  shall  buy  a  soldier, 
though  I  know  perfectly  well  the  penalty  meted  out  to  one  caught  in 
such  circumstances. 

"  I  can  no  longer  do  without  male  love ;  without  it  I  should  always 
be  out  of  harmony  with  myself.  My  ideal  would  be  to  be  associated 
with  a  number  like  myself;  but  I  should  be  satisfied  if  I  could  have 
unrestrained  intercourse  with  one  lovei*.  I  could  easily  dispense  with 
women,  if  I  had  regular  male  satisfaction  ;  but  I  think  that  at  long  inter- 
vals I  should  embrace  a  woman  for  the  sake  of  variety,  as  my  nature  is 
absolutely  hermaphroditic  in  a  psycho-sexual  sense  (women  I  can  only 
desire  sensually,  but  I  can  love  and  sensually  desire  young  men).  If 
there  were  marriage  between  men,  I  think  I  should  not  avoid  a  life-long 
union ;  while  marriage  with  a  woman  seems  to  me  something  impossible. 


248  PSYCHOPATHIA   SEXUALIS. 

For,  in  the  first  place,  though  the  woman  charmed  me,  the  charm  would 
soon  be  lost  in  regular  intercourse,  and  then  all  sexual  indulgence,  if  not 
impossible,  would  certainly  be  devoid  of  pleasure  for  me ;  and,  in  the 
second  place,  true  love  for  the  wife  would  be  wanting — the  attraction  that 
I  feel  with  young  men  I  love,  and  which  makes  the  intercourse  that  is 
not  simply  sensual  seem  desirable  to  me.  The  constant  association  with 
a  youth  physically  pleasing  and  in  mental  harmony  with  me,  and  who 
could  understand  all  mj^  feelings  and  share  my  intellectual  opinions  and 
desires,  would,  it  seems  to  me,  be  the  greatest  happiness. 

"  The  young  men  who  please  me  must  be  between  eighteen  and 
twenty-eight.  As  I  have  grown  older,  the  limit  of  age  in  those  pleasing 
to  me  has  increased  ;  otherwise,  I  am  pleased  with  the  most  various 
forms.  The  principal  role,  if  not  the  exclusive  one,  is  played  by  the  face. 
Blondes  excite  me  more  than  dark  persons ;  they  must  have  no  beard, 
but  merely  a  small  moustache  that  is  not  too  thick,  or  none  at  all.  As 
for  the  rest,  the  only  thing  I  can  say  is,  that  certain  kinds  of  faces  please 
me.  Faces  with  large,  straight  noses  are  excluded,  as  are  also  pale 
cheeks ;  but  there  are  exceptions.  I  regard  soldiers  with  favor,  and 
many  please  me  when  in  uniform  who  do  not  affect  me  when  in  civil 
dress.  Just  as  in  women  certain  ordinary  articles  of  dress  (like  light- 
colored  jackets)  please  me,  so  the  military  costume  attracts  me.  To  go 
to  dance-halls — usually  beer-halls — where  there  are  many  soldiers,  and 
mix  with  the  crowd  of  soldiers  and  boys  that  please  me,  and  try  to  get  a 
kiss  and  embrace, — this  mingling  with  them  would,  of  course,  be  an 
excitant  only  of  sensuality ;  intellectually  and  socially,  everything  com- 
mon in  speech  and  conduct  is  repugnant  to  me. 

"  With  young  men  of  higher  position,  my  sensual  desire  is  less 
prominent. 

"  What  I  have  said  of  the  attractiveness  of  certain  kinds  of  dress 
is  not  to  be  understood  in  the  sense  that  they  attract  me  in  themselves. 
This  charm  only  means  that  the  dress  may  help  to  strengthen  or  make 
prominent  the  attraction  exerted  by  the  face,  when,  perhaps,  the  same 
face  in  itself  would  not  attract  me  to  the  same  extent.  I  may  say  the 
same  thing,  though  with  a  different  meaning,  of  the  odor  of  lighted 
cigars.  In  indifferent  persons  the  odor  of  cigars  is  rather  repugnant 
than  pleasing  to  me,  but  exciting  in  those  sexually  attractive.  The  kiss 
of  a  prostitute  smelling  of  cigar-smoke,  affords  greater  pleasure  (because, 
even  though  in  part  unconsciously,  I  am  reminded  of  the  kiss  of  a  man). 
Therefore,  I  took  pleasure  in  kissing  my  lover  just  after  he  had  smoked. 
(It  is  to  be  noted  that  I  myself  have  never  smoked  a  cigar  or  cigarette, 
and  have  never  even  tried  to  smoke.)  I  am  tall  and  thin;  my  face  is 
masculine ;  my  eyes  are  restless ;  and  in  my  whole  form  I  often  have 
something  girlish.  My  health  leaves  much  to  be  desired.  It  is  much 
influenced  by  my  sexual  anomaly.  As  previously  mentioned,  I  am  very 
nervous,  and  I  often  have  paroxysms  of  onomatomania.   At  times,  I  also 


CONGENITAL   HOMO-SEXUALITY.  249 

have  terrible  depression  and  melancholia,  when  I  see  the  difficulty  of 
gratification  corresponding  with  my  male-loving  nature  ;  and  when  I  am 
greatly  excited  sexually,  and  have  overcome  the  desire,  owing  to  impos- 
sibility of  male  gratification.  In  such  conditions,  often  the  depression 
is  associated  with  absolute  lack  of  sexual  desire.  In  work  I  am  indus- 
trious, but  often  too  quick ;  for  I  am  inclined  to  work  too  rapidly  and 
violently.  I  have  a  lively  interest  in  art  and  literature.  Among  poets 
and  writers  of  fiction,  I  prefer,  for  the  most  part,  those  who  describe 
refined  feelings,  peculiar  passions,  and  far-fetched  impressions ;  an  arti- 
ficial or  hyper-artificial  style  pleases  me.  Likewise  in  music,  it  is  the 
nervous,  exciting  music  of  a  Chopin,  a  Schumann,  a  Schubert,  or  a 
Wagner,  etc.,  that  is  in  most  perfect  harmony  with  me.  Everything  in 
art  that  is  not  only  original,  but  bizarre,  attracts  me. 

"  I  do  not  like  physical  exercise,  and  do  not  practice  it. 

u  In  character  I  am  kind  and  compassionate ;  and,  though  I  have 
much  to  suffer  with  my  anomaly,  I  am  not  unhappy  because  I  love 
3Toung  men,  but  because  the  satisfaction  of  such  love  is  considered 
improper,  and  because  I  cannot  gratify  it  without  restraint.  I  cannot 
regard  male  love  as  a  vice,  though  I  can  well  understand  why  it  is 
considered  vicious.  But,  since  this  love  is  regarded  as  criminal,  in 
gratifying  it  I  am  in  harmony  with  myself,  but  not  with  our  age  of  the 
world  ;  and,  therefore,  I  must,  necessarily,  be  somewhat  depressed  ;  the 
more,  since  I  have  a  frank  character  that  hates  a  lie.  The  pain  of  having 
always  to  hide  it  all  in  myself  has  induced  me  to  confess  my  anomaly  to 
a  few  friends,  of  whose  silence  and  appreciation  I  am  confident.  Never- 
theless, my  situation  often  seems  sad.  On  account  of  the  difficulty  of 
gratification  and  the  general  abhorrence  of  male  love,  I  am  often  a  little 
proud  that  I  have  such  anomalous  feelings.  Of  course,  I  shall  never 
marry.  This  does  not  seem  any  misfortune,  even  though  I  love  family 
life,  and  have  thus  far  lived  only  with  my  parents.  I  live  in  the  hope 
that  later  I  shall  have  a  lover ;  I  must  have  one ;  without  one,  the  future 
seems  dark  and  barren,  and  all  the  ambitions  usually  cherished — honor, 
position,  etc. — seem  empty  and  unattractive.  If  I  should  not  have  this 
hope  fulfilled,  I  know  I  shall  be  unable  to  long  devote  myself  to  m}r  busi- 
ness with  pleasure,  and  I  shall  soon  be  in  a  condition  to  sacrifice  every- 
thing to  obtain  male  love.  I  no  longer  have  any  moral  scruples  on  account 
of  my  anomalous  inclination ;  I  have,  in  fact,  never  been  troubled 
because  I  felt  attracted  to  boys.  I  am  much  more  inclined  to  judge 
morality  and  immorality  in  accordance  with  my  feelings  than  in  accord- 
ance with  fixed  principles;  for  I  have  always  been  given  to  skepticism, 
and  have  never  yet  studied  out  a  fixed  belief  for  myself.  As  yet,  only 
what  injures  others  seems  to  me  to  be  evil  and  immoral,  and  that  that  I 
would  not  have  inflicted  on  myself;  and,  in  this  direction,  I  may  say  that 
I  try  to  infringe  on  the  rights  of  others  as  little  as  possible,  and  that  I 
am  capable  of  great  indignation  at  injustice  inflicted  on  another.     But, 


250  PSYCHOPATHIA    SEXUALIS. 

why  love  of  men  should  be  something  immoral,  I  cannot  understand ; 
purposeless  activity  of  the  sexual  instinct  (if  the  immoral  is  to  be  seen 
in  all  that  is  useless  and  unnatural)  is  also  found  in  intercourse  with 
prostitutes,  and  even  in  marriage  where  means  to  prevent  conception  are 
used ;  and  it  seems  to  me  that  the  sexual  intercourse  of  men  must  be 
placed  on  the  same  level  with  all  sexual  congress  that  has  not  procrea- 
tion as  an  end.  But  that  only  sexual  gratification  that  has  this  pur- 
pose is  moral,  seems  to  me  to  be  questionable.  Certainly,  sexual  satis- 
faction that  is  not  directed  to  procreation  is  not  contrary  to  nature ;  and, 
whether  it  has  not  other  purposes  unknown  to  us,  is  uncertain ;  and, 
even  if  it  were  purposeless,  it  would  not  necessarily  be  despicable  (it  is 
not  certain  that  the  measure  of  a  moral  act  is  its  usefulness). 

"  I  am  very  certain  that  present  prejudice  will  disappear,  and  that 
when  once  such  individuals  experience  male-love,  the  right  of  unrestricted 
love  will  be  acknowledged.  For  the  possibility  of  such  recognition  one 
need  but  recall  the  Greeks  and  their  friendships,  which  were  nothing  but 
sexual  love ;  and  one  has  only  to  think  that,  despite  such  unnatural  vice, 
practiced  by  their  greatest  men  in  intellectual  and  aesthetic  matters,  the 
Greeks  are  still  regarded  as  an  unattainable  example,  and  held  up  for 
imitation. 

"  I  have  already  thought  of  having  my  anomaly  cured  by  hypno- 
tism. If  it  were  to  be  of  any  use,  which  I  doubt,  yet  I  should  certainly 
desire  to  be  assured  of  a  lasting  love  for  women.  For  even  though  I 
cannot  satisfy  myself  with  men,  yet  I  prefer  to  feel  this  capability  of  in- 
ordinate lust  and  love,  even  ungratified,  to  being  absolutely  without  feel- 
ing. Thus  I  still  have  the  hope  that  I  shall  find  opportunity  to  satisfy 
the  love  I  desire,  the  love  that  would  make  me  happy ;  and  I  should  not 
prefer  the  suggestive  removal  of  homo-sexual  feelings,  without  the  simul- 
taneous substitution  of  a  hetero-sexual  equivalent,  to  ray  present  con- 
dition. Finally,  I  should  like  to  add,  in  contrast  with  the  statements  of 
urnings  in  the  published  biographies,  that  I,  at  least,  find  it  very  difficult 
to  recognize  those  like  myself.  Though  I  have  described  my  sexual 
anomaly  somewhat  in  detail,  it  seems  to  me  that  the  following  notes  are 
important  for  a  better  understanding  of  my  condition  : — 

"  Of  late  I  have  given  up  immissio  penis,  and  confined  myself 
to  coitus  inter  femorae  puellae.  Ejaculation  occurs  earlier  than  with 
conjunctio  membrorum,  and  I  experience  a  certain  lustful  feeling  in  the 
penis  itself.  If  this  manner  of  sexual  intercourse  is  quite  pleasant  to 
me,  it  is,  perhaps,  in  part  to  be  referred  to  the  fact  that  in  this  kind  of 
sexual  indulgence  the  sex  is  quite  indifferent,  and  I  am,  perhaps,  uncon- 
sciously reminded  of  masculine  embrace.  But  this  memory  is  abso- 
lutely unconscious,  and  but  obscurely  felt;  for  I  am  not  indebted  to  my 
imagination  for  my  pleasure,  but  it  is  due  immediately  to  kissing  the 
woman's  mouth.  I  feel  that  the  charm  which  the  brothel  and  prostitutes 
have  for  me  also  begins  to  fade ;    but  I  am  sure  certain  women  will 


CONGENITAL   HOMOSEXUALITY.  251 

always  be  able  to  excite  me  by  their  kisses.  Still,  no  woman  is,  or  ever 
will  be,  so  attractive  as  to  induce  me  to  overcome  obstacles  in  winning 
her ;  but  even  the  danger  of  discovery  and  disgrace  could  only  with 
difficulty  restrain  me  from  seeking  a  man's  embraces. 

"  Thus  I  lately  allowed  myself  to  be  induced  to  buy  a  soldier  at  a 
prostitute's  house.  The  lustful  pleasure  was  very  great,  but  the  subse- 
quent feeling  of  satisfaction  was  especially  very  exhilarating.  The  next 
day  I  felt  similarly  strengthened  (capable  of  erection  at  any  moment)  ; 
and  though  I  have  not  yet  been  able  to  meet  the  soldier  again,  the 
thought  that  I  shall  venture  to  purchase  another  gives  me  peace.  But  I 
could  be  perfectly  satisfied  only  in  finding  one  feeling  like  myself,  of  my 
own  position  and  education. 

"  I  have  not  yet  mentioned  that  the  female  form  (with  the  exception 
of  the  face)  and  genitals  have  no  attraction  for  me  (to  touch  the  latter 
with  my  hand  would  be  disgusting  to  me)  ;  but  membrum  virile  me 
tangere  dum  os  meum  os  ejus  osculatur,  mihi  exoptatum  esse  ;  indeed, 
to  kiss  that  of  a  very  pleasing  man  would  not  be  disgusting  to  me. 
Onanism,  as  has  been  said,  would  be  quite  impossible  for  me." 

Case  111.  Psychical  Hermaphroditism. — Hetero-sexual  feeling  early 
interfered  with  by  masturbation,  but  episodically  very  intense.  Homo- 
sexual feeling  ab  origine  perverse  (sexual  excitation  by  men's  boots). 

Mr.  X.,  of  high  social  position,  Russian,  aged  28,  came  to  me  in 
September,  1887,  in  a  despairing  mood,  to  consult  me  on  account  of  a 
perversion  of  his  vita  sexualis,  which  made  life  seem  almost  unbearable  to 
him,  and  which  had  repeatedly  brought  him  near  to  suicide.  The  patient 
comes  of  a  family  in  which  neuroses  and  psychoses  have  been  of  frequent 
occurrence.  In  the  father's  family  there  had  been  consanguineous  mar- 
riages for  three  generations.  The  father  is  said  to  have  been  a  healthy 
man,  and  to  have  lived  morally  in  marriage.  However,  his  father's 
preference  for  fine-looking  servants  seems  remarkable  to  the  son.  The 
mother's  family  is  described  as  eccentric.  The  mother's  grandfather  and 
great-grandfather  died  melancholic;  her  sister  was  insane;  a  daughter 
of  the  grandfather's  brother  was  hysterical,  and  had  nymphomania.  Only 
three  of  the  mother's  twelve  brothers  and  sisters  married.  Of  these,  one 
brother  was  homo-sexual,  and  always  nervous  as  a  result  of  excessive 
masturbation. 

The  patient's  mother  is  said  to  be  a  bigot,  and  of  small  mental 
endowment,  nervous,  irritable,  and  inclined  to  melancholia.  Patient 
has  a  sister  and  a  brother.  The  brother  is  frequently  melancholy, 
and,  though  mature,  has  never  shown  the  slightest  trace  of  sexual 
inclinations.  The  sister  is  an  acknowledged  beauty,  and  much  sought 
by  gentlemen.  This  lady  is  married,  but  childless,  as  reported,  owing  to 
the  impotence  of  her  husband.  She  has  always  been  indifferent  to  the 
attentions  shown  her  by  men,  but  is  charmed  by  female  beaut}',  and 
actually  in  love  with  some  of  her  female  friends. 


252  PSYCHOPATHIA   SEXUALIS. 

With  respect  of  himself,  the  patient  asserts  that,  when  four  years 
old,  he  dreamed  of  handsome  jockeys  wearing  shining  boots.  Too,  he 
never  dreamed  of  women  when  he  grew  older.  His  nightly  pollutions 
were  always  induced  by  "  boot-dreams."  From  his  fourth  jrear  he  had  a 
peculiar  partiality  for  men,  or,  more  correctly,  for  lackeys  wearing 
shining  boots.  At  first  they  only  excited  his  interest,  but,  with  devel- 
opment of  his  sexual  functions,  the  sight  of  them  caused  powerful 
erections  and  lustful  pleasure.  It  was  only  servants'  boots  that  affected 
him ;  the  same  kind  of  boots  on  persons  of  like  social  station  were  with- 
out effect  on  him.  In  a  homo-sexual  sense,  there  was  no  sexual  impulse 
connected  with  these  situations.  Even  the  thought  of  such  a  possibility 
was  disgusting  to  him.  At  times,  however,  he  had  sensually-colored 
ideas, — like  being  his  servant's  servant,  and  drawing  off  his  boots ;  but 
the  idea  of  being  stepped  on  by  him,  or  of  having  to  blacken  his  boots, 
was  most  pleasing.  The  pride  of  the  aristocrat  rose  up  against  such 
thoughts.  In  general,  these  notions  about  boots  were  disgusting  and 
painful  to  him. 

Sexual  instinct  was  early  and  powerfully  developed.  It  first  found 
expression  in  indulgence  in  sensual  thoughts  about  boots,  and,  after 
puberty,  in  dreams  accompanied  by  pollutions  ;  otherwise,  the  mental  and 
physical  development  was  undisturbed.  Patient  was  well  endowed  men- 
tally,— learned  easily,  finished  his  studies,  and  became  an  officer.  On 
account  of  his  distinguished,  manly  appearance  and  his  high  position,  he 
was  much  sought  in  society. 

He  characterizes  himself  as  a  clever,  quiet,  strong-willed,  but  super- 
ficial man.  He  asserts  that  he  is  a  passionate  hunter  and  rider,  and  that 
he  lias  never  had  any  inclination  for  feminine  pursuits.  In  the  society 
of  ladies  he  has  always  been  reserved  ;  dancing  always  tired  him.  He 
had  never  had  any  interest  in  a  lady  of  high  social  position.  As  for 
women,  only  the  buxom  peasant  girls,  such  as  are  the  models  of  painters 
in  Rome,  had  interested  him.  He  had,  however,  never  felt  any  sexual 
interest  in  such  representatives  of  the  female  sex.  In  the  theatre  and 
circus  only  male  performers  had  excited  his  interest;  but,  at  the  same 
time,  they  had  caused  him  no  sensual  feelings.  As  for  men,  only  their 
boots  excited  him,  and,  indeed,  only  when  the  wearers  belonged  to  the 
servant  class  and  were  handsome  men.  Men  of  his  own  position,  wear- 
ing never  so  fine  boots,  were  absolutely  indifferent  to  him. 

With  reference  to  his  sexual  inclinations,  the  patient  is  still  uncer- 
tain whether  he  feels  more  inclination  toward  the  opposite  sex  or  toward 
his  own  sex.  He  is  inclined  to  think  that  originally  he  had  more  in- 
clination for  women,  but  that  this  sympathy  was,  in  any  case,  very  weak. 
He  states  with  certainty  that  the  sight  of  a  naked  man  made  no  impres- 
sion on  him,  and  that  the  sight  of  male  genitals  was  even  repugnant  to 
him.  In  the  case  of  women,  this  was  not  exactly  the  case,  but  he  was 
not  excited  sexually  even  by  the  most  beautiful  feminine  form.     When  a 


CONGENITAL   HOMO-SEXUALITY.  253 

young  officer,  he  was  now  and  then  compelled  to  accompany  his  comrades 
to  brothels.  He  was  the  more  easily  persuaded  to  this,  since  he  hoped  by 
this  means  to  be  rid  of  his  vile  partiality  for  boots  ;  but  he  was  impotent 
unless  he  brought  the  thought  of  boots  to  his  aid.  Under  such  circum- 
stances, the  act  of  cohabitation  was  normally  performed,  but  without 
pleasurable  feeling.  Patient  felt  no  impulse  to  intercourse  with  women, 
always  requiring  some  external  cause, — i.e.,  persuasion.  Left  to  himself, 
his  vita  sexualis  consisted  in  reveling  in  ideas  about  boots,  and  in  corre- 
sponding dreams  with  pollutions.  Since  more  and  more  there  became 
connected  with  them  the  impulse  to  kiss  his  servant's  boots,  to  draw 
them  off,  etc.,  the  patient  determined  to  use  every  means  to  rid  himself 
of  this  disgusting  desire,  which  deeply  wounded  his  pride.  At  that 
time,  being  in  his  twentieth  year,  and  in  Paris,  he  recalled  a  very  beautiful 
peasant  girl,  who  lived  in  his  distant  home.  He  hoped,  with  her  assist- 
ance, to  free  himself  of  his  perverse  sexual  inclination.  He  went  dh'ectly 
home,  and  tried  to  win  the  girl's  favor.  It  seems  that  the  patient  was 
not  naturally  homo-sexual.  He  asserts  that  at  that  time  he  was  actually 
in  love  with  this  person,  and  that  her  glance,  or  the  touch  of  her  dress, 
gave  him  sensual  pleasure;  and,  when  she  once  kissed  him,  he  had  a 
powerful  erection.  After  about  a  year  and  a  half,  the  patient  succeeded 
in  gaining  his  desires  with  this  person. 

He  was  potent,  but  ejaculated  tardily  (ten  to  twenty  minutes),  and 
never  had  a  pleasurable  feeling  in  the  act. 

After  about  a  year  and  a  half  of  sexual  intercourse  with  this 
girl,  his  love  for  her  grew  cold,  because  he  did  not  find  her  so  "  fine 
and  pure  "  as  he  wished.  From  this  time  it  was  necessary  for  him  to 
call  upon  ideas  about  boots  for  help,  which  had  been  latent,  in  order 
to  be  potent  in  sexual  intercourse  with  her.  In  proportion  as  his  power 
failed,  these  ideas  arose  spontaneously.  Thereafter  he  had  coitus  with 
other  women.  Now  and  then,  especially  when  the  woman  was  in  sym- 
pathy with  him,  the  act  took  place  without  any  assistance  of  imagina- 
tion. It  once  happened  that  the  patient  committed  a  rape.  It  is 
remarkable  that  on  this  single  occasion  he  had  a  pleasurable  feeling 
in  the  (forced)  act.  Immediately  after  the  deed  he  had  a  feeling  of 
disgust.  When,  an  hour  after  the  forced  indulgence,  he  had  coitus  with 
the  same  woman,  with  her  consent,  he  experienced  no  feeling  of 
pleasure. 

With  decrease  of  virility, — i.e.,  when  it  was  preserved  only  in  con- 
nection with  ideas  about  boots, — libido  for  the  opposite  sex  decreased. 
The  patient's  slight  libido  and  weak  inclination  for  women  are  evidenced 
by  the  fact  that,  while  he  still  sustained  sexual  relations  with  the  peasant 
girl,  he  began  to  masturbate.  He  learned  the  vice  from  "  Rousseau's 
Confessions,"  the  book  accidentally  falling  into  his  hands. "  The  boot- 
fancies  immediately  linked  themselves  with  corresponding  impulses. 
He  then  had  violent  erections,  masturbated,  and   ejaculation   afforded 


254  PSYCHOPATHIA   SEXUALIS. 

him  a  lively  feeling  of  pleasure,  which  was  denied  to  him  in  coitus ;  and 
at  first  he  felt  himself  fresher  and  brighter,  as  a  result  of  the  masturba- 
tion. 

In  time,  however,  symptoms  of  sexual,  and,  later,  of  general, 
neurasthenia,  with  spinal  irritation,  appeared.  He  then  at  first  gave 
up  masturbation,  and  sought  his  first  love;  but  she  was  now  more  than 
ever  indifferent  to  him.  Since  he  finally  became  impotent,  even  when  he 
called  ideas  of  boots  to  his  assistance,  he  gave  up  women  entirely,  and 
again  practiced  masturbation  ;  by  which  he  felt  himself  protected  from 
the  impulse  to  kiss  and  blacken  servants'  boots.  At  the  same  time,  he 
continued  to  feel  that  his  sexual  position  was  a  painful  one.  He  again 
occasionally  attempted  coitus,  and  was  successful  in  it  as  soon  as  he 
thought  of  blackened  boots.  Too,  after  continued  abstinence  from  mas- 
turbation, he  was  sometimes  successful  in  coitus  without  any  artificial 
aid. 

The  patient  says  that  his  sexual  needs  are  intense.  If  he  has  not 
had  an  ejaculation  in  a  long  time,  he  becomes  congestive  and  psychically 
much  excited,  and  tormented  by  repugnant  images  of  boots,  so  that  he 
is  forced  to  have  coitus,  or,  preferably,  to  masturbate. 

For  some  time  his  moral  position  has  been  complicated  most  pain- 
fully by  the  fact  that,  as  the  last  of  a  wealthy  line  of  high  position,  and 
at  the  importunate  desire  of  his  parents,  he  must  marry.  The  bride  is 
of  rare  beauty,  and  mentally  in  perfect  sympathy  with  him  ;  but,  as  a 
woman,  she  is  as  indifferent  to  him  as  any  other.  ^Esthetically  she  sat- 
isfies him  "  as  a  work  of  "art ;  "  in  his  eyes,  she  is  an  ideal.  To  honor 
her  in  a  platonic  way  would  be  happiness  worth  striving  for;  but  to 
possess  her  as  a  wife  is  a  painful  thought.  He  is  certain  beforehand 
that  with  her  he  will  be  impotent,  save  with  the  help  of  ideas  of  boots. 
To  use  such  means,  however,  is  in  opposition  to  his  respect  and  his 
moral  and  aesthetic  feeling  for  the  lady.  Were  he  to  soil  her  with  such 
thoughts,  she  would  lose,  in  his  eyes,  all  her  aesthetic  value;  and  then  he 
would  become  impotent  for  her,  and  she  would  become  repugnant  to 
him.  The  patient  considers  his  position  one  of  despair,  and  confesses 
that  he  has  lately  been  repeatedly  near  suicide. 

He  is  a  man  of  much  intelligence,  and  decidedly  of  masculine  appear- 
ance, with  abundant  growth  of  beard,  deep  voice,  and  normal  genitals. 
The  eye  has  a  neuropathic  expression.  No  signs  of  degeneration. 
Symptoms  of  spinal  neurasthenia.  It  was  possible  to  reassure  the 
patient,  and  give  him  hope  of  his  future. 

The  medical  advice  consisted  in  means  for  combating  the  neuras- 
thenia, and  the  interdiction  of  masturbation  and  indulgence  of  the  fancy 
in  images  of  boots,  in  the  hope  that,  with  the  removal  of  the  neuras- 
thenia, cohabitation  without  ideas  of  boots  would  become  possible ;  and 
that,  in  time,  the  patient  would  become  morally  and  physically  capable 
of  marriage. 


URNINGS.  255 

In  the  latter  part  of  October,  1888,  the  patient  wrote  me  that  he 
had  resolutely  resisted  masturbation  and  his  imagination.  In  the  inter- 
val he  had  had  but  one  dream  about  boots,  and  scarcely  a  pollution. 
He  had  been  free  from  homo-sexual  inclinations,  but,  in  spite  of  this, 
there  was  often  considerable  sexual  excitement,  without  anything  like 
adequate  libido  for  women.  In  this  deplorable  situation,  he  was  com- 
pelled, by  circumstances,  to  marry  in  three  months. 

2.  Homo-Sexual  Individuals,  or  Urnings. — In  distinction 
from  the  preceding  group  of  psycho-sexual  hermaphrodites, 
there  are  here,  ah  origine,  sexual  desires  and  inclinations  for 
persons  of  the  same  sex  exclusively ;  but,  in  contrast  with  the 
following  group,  the  anomaly  is  limited  to  the  vita  sexualis,  and 
does  not  more  deeply  and  seriously  affect  the  character  and 
mental  personality. 

The  vita  sexualis  of  these  urnings,  mutatis  mutandis,  is 
entirely  like  that  in  normal  hetero-sexual  love ;  but,  since  it  is 
the  exact  opposite  of  the  natural  feeling,  it  becomes  a  carica- 
ture, and  this  the  more,  since  these  individuals,  at  the  same  time, 
as  a  rule,  are  subject  to  hyperesthesia  sexualis,  and,  therefore, 
their  love  for  their  own  sex  is  emotional  and  passionate. 

The  urning  loves  and  deifies  the  male  object  of  his  affec- 
tions, just  as  a  man  idealizes  the  woman  he  loves.  He  is 
capable  of  the  greatest  sacrifice  for  him,  and  experiences  the 
pangs  of  unfortunate,  often  unrequited,  love ;  suffers  from  the 
unfaithfulness  of  the  beloved  object,  and  is  subject  to 
jealousy,  etc. 

The  attention  of  the  male-loving  man  is  given  only  to  male 
dancers,  actors,  athletes1  statues,  etc.  The  sight  of  female 
charms  is  indifferent  to  him,  if  not  repulsive.  A  naked  woman 
is  disgusting  to  him,  while  the  sight  of  male  genitals,  hips,  etc., 
affords  him  infinite  pleasure. 

The  bodily  contact  of  a  sympathetic  man  induces  a  thrill 
of  delight;  and,  since  such  individuals  are  mostly  sexually 
neurasthenic,  congenitally  or  from  onanism  or  enforced  absti- 
nence from  sexual  intercourse,  under  such  circumstances  ejac- 
ulation is  very  easily  induced,  which,  in  the  most  intimate 
intercourse  with  women,  cannot  be  induced  at  all,  or  only 
by  mechanical  means.     The  sexual  act  with  a  man,  in  many 


256  PSYCHOPATHIA   SEXUALIS. 

instances,  affords  pleasure,  and  leaves  behind  a  feeling  of  well- 
being.  Should  the  urning  be  able  to  force  himself  to  coitus,  in 
which,  as  a  rule,  disgust  has  the  effect  of  an  inhibitory  con- 
cept, and  makes  the  act  impossible,  then  his  feeling  is  something 
like  that  of  a  man  compelled  to  take  disgusting  food  or  drink. 
However,  experience  teaches  that  not  infrequently  urnings 
falling  in  this  group  marry,  either  out  of  ethical  or  social  con- 
siderations. 

Such  unfortunates  are  relatively  potent,  in  that  in  marital 
intercourse  they  incite  their  imagination,  and,  instead  of  think- 
ing of  their  wives,  they  call  up  the  image  of  some  loved  male 
person.  But  for  them  coitus  is  a  great  sacrifice,  and  no  pleasure; 
and  it  makes  them,  for  days  after,  nervous  and  miserable.  If 
such  urnings,  by  means  of  powerful  excitation  of  their  imagina- 
tion, or  under  the  influence  of  alcoholic  drinks,  or  by  erections 
induced  by  an  overfilled  bladder,  etc.,  are  enabled  to  overcome 
the  inhibitory  feelings  and  ideas,  then  they  are  still  entirely  im- 
potent ;  while  simply  the  touch  of  a  man  may  induce  powerful 
erection,  and  even  ejaculation. 

Dancing  with  a  woman  is  unpleasant  to  an  urning,  but  to 
dance  with  a  man,  especially  one  with  an  attractive  form,  seems 
to  him  the  greatest  of  pleasures.  The  male  urning,  in  so  far  as 
he  possesses  higher  culture,  is  not  opposed  to  non-sexual  inter- 
course with  women,  when  by  mind  and  refinement  they  make  con- 
versation pleasant.  It  is  only  of  woman  in  her  sexual  role  that 
he  has  a  horror.  The  homo-sexual  woman  offers  the  same  mani- 
festations, mutatis  mutandis.  In  this  degree  of  sexual  degen- 
eration, character  and  occupation  correspond  with  the  sex  which 
the  individual  represents.  The  sexual  perversion  remains  iso- 
lated, but  an  anomaly  of  the  mental  being  of  the  individual 
which  deeply  affects  the  social  existence.  In  accordance  with 
this,  many  of  these  individuals,  in  the  sexual  act,  feel  themselves 
in  the  role  which  would  naturally  belong  to  them  in  hetero- 
sexual intercourse. 

However,  transitions  to  group  3  occur,  in  as  much  as  some- 
times the  passive  role  which  corresponds  with  the  homo-sexual 
manner  of  feeling,  is  thought  of  or  desired,  or  at  least  forms 


URNINGS.  257 

the  subject  of  dreams.  Moreover,  inclinations  for  occupations 
and  tendencies  of  taste  are  manifested,  which  do  not  correspond 
with  the  sex  of  the  individual.  In  many  cases,  one  gets  the 
impression  that  such  symptoms  are  artificial,  the  result  of  educa- 
tional influences;  in  other  cases,  that  they  represent  deeper 
acquired  degenerations  of  the  original  anomaly,  induced  by  the 
perverse  sexual  activity  (masturbation),  analogous  to  the  signs 
of  progressive  degeneration  observed  in  acquired  inversion  of 
the  sexual  instinct. 

With  regard  to  the  manner  of  sexual  satisfaction,  it  must 
be  stated  that  with  many  male  timings  simple  embraces  are 
sufficient  to  induce  ejaculation,  since  they  are  subject  to  irritable 
weakness  of  the  sexual  apparatus.  In  case  of  sexual  hyperes- 
thesia, and  where  there  is  paresthesia  of  the  moral  sense,  great 
pleasure  is  afforded  by  intercourse  with  persons  of  the  lowest 
condition.  On  the  same  basis,  desires  to  commit  pederasty 
(active,  of  course)  and  other  similar  acts  occur,  though  it  is  but 
seldom,  and  apparently  only  in  cases  of  moral  defect,  and  by 
reason  of  libido  nimia  in  individuals  especially  passionate,  that 
pederasty  is  indulged  in.  The  sensual  desire  of  mature  timings, 
in  contradistinction  from  old  and  decrepit  debauchees,  who 
prefer  boys  (and  indulge  in  pederasty  by  preference),  seems 
never  to  be  directed  to  immature  males.  Only  for  want  of  better 
material,  and  in  case  of  violent  passion,  does  the  uming  become 
dangerous  to  boys.  The  manner  of  sexual  satisfaction  in  female 
timings  may  be  mutual  and  passive  masturbation.  To  them 
coitus  is  quite  as  disgusting,  wearisome,  and  inadequate  as  it  is 
to  the  male  timing. 

Case  112.  The  following  is  an  extract  from  a  very  circumstantial 
autobiography  which  a  physician  affected  with  contrary  sexual  instinct 
has  put  at  my  disposal : — 

"  I  am  now  forty  years  old,  of  healthy  family,1  and  have  always 
been  healthy  and  considered  a  model  of  physical  and  mental  strength 
and  energy.  I  am  of  powerful  build,  but  have  only  a  moderate  beard, 
and,  with  the  exception  of  hair  in  the  axilloe  and  on  the  mons  veneris, 

1  Later  it  became  known  that  a  near  relative  died  insane,  and,  further,  that  eight  of 
his  parent's  children  had  died  of  acute  or  chronic  hydrocephalus  at  ages  ranging  from  one 
to  fifteen. 

17 


256  PSYCHOPATHIA   SEXUALIS. 

instances,  affords  pleasure,  and  leaves  behind  a  feeling  of  well- 
being.  Should  the  urning  be  able  to  force  himself  to  coitus,  in 
which,  as  a  rule,  disgust  has  the  effect  of  an  inhibitory  con- 
cept, and  makes  the  act  impossible,  then  his  feeling  is  something 
like  that  of  a  man  compelled  to  take  disgusting  food  or  drink. 
However,  experience  teaches  that  not  infrequently  timings 
falling  in  this  group  marry,  either  out  of  ethical  or  social  con- 
siderations. 

Such  unfortunates  are  relatively  potent,  in  that  in  marital 
intercourse  they  incite  their  imagination,  and,  instead  of  think- 
ing of  their  wives,  they  call  up  the  image  of  some  loved  male 
person.  But  for  them  coitus  is  a  great  sacrifice,  and  no  pleasure; 
and  it  makes  them,  for  days  after,  nervous  and  miserable.  If 
such  urnings,  by  means  of  powerful  excitation  of  their  imagina- 
tion, or  under  the  influence  of  alcoholic  drinks,  or  by  erections 
induced  by  an  overfilled  bladder,  etc.,  are  enabled  to  overcome 
the  inhibitory  feelings  and  ideas,  then  they  are  still  entirely  im- 
potent ;  while  simply  the  touch  of  a  man  may  induce  powerful 
erection,  and  even  ejaculation. 

Dancing  with  a  woman  is  unpleasant  to  an  urning,  but  to 
dance  with  a  man,  especially  one  with  an  attractive  form,  seems 
to  him  the  greatest  of  pleasures.  The  male  urning,  in  so  far  as 
he  possesses  higher  culture,  is  not  opposed  to  non-sexual  inter- 
course with  women,  when  by  mind  and  refinement  they  make  con- 
versation pleasant.  It  is  only  of  woman  in  her  sexual  role  that 
he  has  a  horror.  The  homo-sexual  woman  offers  the  same  mani- 
festations, mutatis  mutandis.  In  this  degree  of  sexual  degen- 
eration, character  and  occupation  correspond  with  the  sex  which 
the  individual  represents.  The  sexual  perversion  remains  iso- 
lated, but  an  anomaly  of  the  mental  being  of  the  individual 
which  deeply  affects  the  social  existence.  In  accordance  with 
this,  many  of  these  individuals,  in  the  sexual  act,  feel  themselves 
in  the  role  which  would  naturally  belong  to  them  in  hetero- 
sexual intercourse. 

However,  transitions  to  group  3  occur,  in  as  much  as  some- 
times the  passive  role  which  corresponds  with  the  homo-sexual 
manner  of  feeling,  is  thought  of  or  desired,  or  at  least  forms 


URNINGS.  257 

the  subject  of  dreams.  Moreover,  inclinations  for  occupations 
and  tendencies  of  taste  are  manifested,  which  do  not  correspond 
with  the  sex  of  the  individual.  In  many  cases,  one  gets  the 
impression  that  such  symptoms  are  artificial,  the  result  of  educa- 
tional influences;  in  other  cases,  that  they  represent  deeper 
acquired  degenerations  of  the  original  anomaly,  induced  by  the 
perverse  sexual  activity  (masturbation),  analogous  to  the  signs 
of  progressive  degeneration  observed  in  acquired  inversion  of 
the  sexual  instinct. 

With  regard  to  the  manner  of  sexual  satisfaction,  it  must 
be  stated  that  with  many  male  urnings  simple  embraces  are 
sufficient  to  induce  ejaculation,  since  they  are  subject  to  irritable 
weakness  of  the  sexual  apparatus.  In  case  of  sexual  hyperes- 
thesia, and  where  there  is  paresthesia  of  the  moral  sense,  great 
pleasure  is  afforded  by  intercourse  with  persons  of  the  lowest 
condition.  On  the  same  basis,  desires  to  commit  pederasty 
(active,  of  course)  and  other  similar  acts  occur,  though  it  is  but 
seldom,  and  apparently  only  in  cases  of  moral  defect,  and  by 
reason  of  libido  nimia  in  individuals  especially  passionate,  that 
pederasty  is  indulged  in.  The  sensual  desire  of  mature  urnings, 
in  contradistinction  from  old  and  decrepit  debauchees,  who 
prefer  boys  (and  indulge  in  pederasty  by  preference),  seems 
never  to  be  directed  to  immature  males.  Only  for  want  of  better 
material,  and  in  case  of  violent  passion,  does  the  uming  become 
dangerous  to  boys.  The  manner  of  sexual  satisfaction  in  female 
urnings  may  be  mutual  and  passive  masturbation.  To  them 
coitus  is  quite  as  disgusting,  wearisome,  and  inadequate  as  it  is 
to  the  male  uming. 

Case  112.  The  following  is  an  extract  from  a  very  circumstantial 
autobiography  which  a  physician  affected  with  contrary  sexual  instinct 
has  put  at  my  disposal : — 

"  I  am  now  forty  3'ears  old,  of  healthy  family, 1  and  have  always 
been  healthy  and  considered  a  model  of  physical  and  mental  strength 
and  energy.  I  am  of  powerful  build,  but  have  only  a  moderate  beard, 
and,  with  the  exception  of  hair  in  the  axillae  and  on  the  mons  veneris, 

1  Later  it  became  known  that  a  near  relative  died  insane,  and,  further,  that  eight  of 
his  parent's  children  had  died  of  acute  or  chronic  hydrocephalus  at  ages  ranging  from  one 
to  fifteen. 

17 


260  PSYCHOPATHIA   SEXUALIS. 

ment  mentally,  possessing  a  powerful  sexual  desire  that  had  been  mani- 
fested abnormally  early,  had  indulged  in  urnings'  love  since  his  sixth 
year.  Once  a  month  he  visited  the  Capital.  I  had  to  sleep  with  him. 
He  was  insatiable  in  mutual  onanism,  and  made  me  take  part  in  active 
and  passive  pederasty,  which  was  an  unpleasant  part  of  the  bargain 
for  me." 

"  B.,  a  merchant,  aged  36,  of  masculine  appearance,  was  as  passionate 
as  I  was.  He  knew  how  to  make  his  manipulations  on  me  such  a  stim- 
ulus that  I  had  to  serve  him  passively  in  pederasty.  He  was  the  only 
one  with  whom  I  ever  had  any  pleasure  in  passive  pederasty.  He  con- 
fessed to  me  that  when  he  but  knew  that  I  was  near,  he  had  the  most 
painful  erections;  and  that  when  I  could  not  serve  him,  he  was  compelled 
to  satisfy  himself  by  masturbation. 

"  While  pursuing  these  love-affairs,  I  was  clinical  assistant  in  hos- 
pital, and  was  considered  ambitious  and  skillful  in  my  work.  I  naturally 
sought  throughout  literature  for  an  explanation  of  my  sexual  peculiarity. 
I  found  it  in  part  as  a  crime  deserving  punishment,  while  for  myself  I 
could  only  recognize  in  it  the  natural  satisfaction  of  my  sexual  desire. 
I  was  aware  that  this  was  congenital  with  me.  But  feeling  myself  in  oppo- 
sition to  the  whole  world,  often  near  insanity  and  suicide,  I  again  sought 
to  satisfy  my  powerful  sexual  desire  with  women.  The  result  was  always 
the  same, — either  want  of  sufficient  erection,  or,  when  it  became  possible, 
to  force  myself  to  the  act,  disgust  and  horror  of  its  repetition.  As  a 
military  surgeon,  I  suffered  terribly  from  the  sight  and  touch  of  thousands 
of  naked  male  forms.  Fortunately,  I  formed  a  love-bond  with  a  lieu- 
tenant affected  similarly,  and  passed  again  a  time  of  happiness.  For 
love  of  him  I  consented  to  pederasty,  for  which  he  longed.  We  loved 
each  other  until  he  lost  his  life  at  Sedan.  From  that  time  I  never  gave 
myself  to  active  or  passive  pederasty,  although  I  had  many  love-affairs, 
and  was  a  person  much  sought. 

"At  twenty -three  I  went  to  the  country  as  a  pl^'sician,  and  was 
sought  and  esteemed.  I  satisfied  myself  with  boys  over  fourteen.  I 
interested  myself  in  political  affairs,  and  made  an  enemy  of  the  clergy- 
man, and,  being  betrayed  by  one  of  my  lovers,  was  denounced  and  com- 
pelled to  flee.  The  legal  investigation,  fortunately,  did  me  no  harm.  I 
was  able  to  return,  but  I  was  greatly  shaken  ;  and  I  went  to  the  war 
(1870)  as  a  soldier,  in  the  hope  of  meeting  my  death.  I  returned,  how- 
ever, with  many  distinctions,  much  matured;  and  I  found  still  more 
pleasure  in  earnest  work  in  my  profession.  I  hoped  that  the  extinction 
of  my  excessive  sexual  desire  was  near  at  hand,  exhausted  by  the  great 
hardships  of  the  campaign. 

"  Scarcely  had  I  recovered,  when  the  old  unbounded  desire  again 
appeared,  and  led  to  new  unbridled  satisfaction.  Of  course,  I  often 
thonglit  ef  it ;  but  my  inclination,  so  revolting  to  the  world,  did  not  seem 
so  to  me. 


URNINGS.  261 

"  For  a  year,  by  means  of  the  greatest  exercise  of  my  will,  I  ab- 
stained ;  then  I  went  to  the  Capital  to  force  myself  to  cohabit  with  a 
woman.  I,  who  at  the  sight  of  the  dirtiest  ragamuffin  had  painful  erec- 
tions, could  scarcely  induce  one  with  the  most  beautiful  woman.  Over- 
come, I  returned  home  and  obtained  a  young  man-servant  for  my  personal 
service  and  satisfaction. 

"  The  solitude  of  life  as  a  country  physician,  and  the  longing  for 
children,  drove  me  to  marriage;  besides,  I  wished  to  make  an  end  to 
gossip,  and  I  hoped  finally  to  triumph  over  my  fatal  desire. 

"  I  knew  a  young  girl,  of  whose  respect  and  love  for  me  I  was  con- 
vinced. Through  my  esteem  and  honor  for  my  wife,  I  was  enabled  to 
perform  the  conjugal  duties,  and  begat  four  boys.  The  boyish  appear- 
ance of  my  wife  was  of  effectual  assistance.  I  called  her  my  '  Raphael.' 
I  forced  into  my  fancy  images  of  boys,  in  order  to  induce  erection.  If 
my  fancy  ceased  for  a  moment,  the  erection  failed.  I  was  unable  to 
sleep  with  my  wife.  Within  the  last  few  years  coitus  has  become  con- 
stantly more  difficult  to  attain,  and  for  two  }*ears  we  have  given  up  all 
attempts.  My  wife  knows  my  mental  condition,  and  her  esteem  and 
love  for  me  may  become  estranged. 

"My  sexual  inclination  for  my  own  sex  is  unchanged,  and,  unfor- 
tunately, too  often  forces  me  to  become  untrue  to  my  wife.  To  this  day, 
the  sight  of  a  youth  of  sixteen  puts  me  into  violent  sexual  excitement 
with  painful  erections,  so  that  occasionally  I  am  compelled  to  help  myself 
with  man  ustu  prat  ion  of  him  and  onanism  on  nvyself. 

"  The  sufferings  I  endure  are  indescrible.  Faute  de  mieux,  I  have 
my  wife  practice  manustupration  on  me  ;  but  what  my  wife's  hand  accom- 
plishes with  great  effort  in  half  an  hour  is  produced  by  the  hand  of  a 
boy  in  a  few  seconds.  Thus  I  live,  miserable,  a  slave  of  the  law  and  of 
my  duty  to  my  wife  !  I  never  had  pleasure  in  active  or  passive  pederasty. 
If  I  ever  practiced  or  suffered  it,  it  was  only  from  gratitude  or  desire  to 
please." 

The  physician  to  whom  I  owe  the  preceding  autobiography 
assures  me  that  he,  up  to  this  time,  has  had  sexual  intercourse 
with  at  least  six  hundred  urnings.  There  were,  indeed,  many 
among  them  who  to-day  occupy  high  and  respected  positions. 
Only  about  ten  per  cent,  of  them  came  later  to  love  women. 
Another  portion  did  not  avoid  women,  but  were  more  inclined 
to  their  own  sex ;  the  remainder  were  exclusively  and  lastingly 
urnings. 

This  physician  asserted  that  among  the  six  hundred  he 
never  found  abnormal  formation  of  the  genitals ;  but  there  were, 
however,  frequent  approaches  to  the  female  form,  as  well  as  in- 


262  PSYCHOPATHIA  SEXtJALIS. 

complete  growth  of  hair,  delicate  complexion,  and  higher  voice. 
Development  of  the  mammae  was  not  infrequent.  He  asserted 
that  from  his  thirteenth  to  his  fifteenth  year  he  had  milk  in  his 
mammae,  which  his  friend  H.  sucked  out.  Only  about  ten  per 
cent,  of  this  number  showed  inclination  for  female  occupations, 
etc.  All  his,  acquaintances  were  affected  with  a  sexual  desire 
that  was  abnormally  powerful,  and  made  its  appearance  abnor- 
mally early.  The  vast  majority  felt  themselves  as  the  man  in 
their  relations  with  the  other,  and  satisfied  themselves  by  mutual 
onanism,  or  by  manustupration  on  the  person  of  the  lover,  or  by 
masturbation  at  his  hands.  The  majority  were  inclined  to  active 
pederasty ;  but  very  frequently  the  law  and  aesthetic  feeling  were 
reasons  for  the  non-performance  of  the  act.  Those  feeling  them- 
selves toward  the  others  as  women  were  few,  and  the  inclination 
to  passive  pederasty  was  very  infrequent. 

In  the  beginning  of  1887,  this  physician  was  arrested  for  having 
commited  acts  of  indecency  on  the  persons  of  two  boys  under  fourteen 
years.  The  crime  consisted  in  his  having  first  rubbed  mentulam  pro- 
priam  inter  femora  viri  until  ejacnlatio,  and  the  same  procedure  cum 
mentula  propria  inter  femora  pueri.  At  the  examination  it  was  recog- 
nized that  an  abnormal  instinct  was  in  play,  though,  at  the  same  time,  it 
was  shown  that  the  culprit  was  not  mentally  unsound,  and  not  deprived 
of  free  will ;  at  least,  he  had  not  acted  in  obedience  to  an  uncontrollable 
impulse.  Therefore,  he  was  sentenced  to  prison  for  one  year,  the  mildest 
possible  punishment. 

Case  113.  Mi*.  X.,  Hungarian,  merchant,  consulted  me  on  account 
of  neurasthenia  and  sleeplessness,  which  had  existed  for  j^ears.  The  in- 
vestigation of  the  cause  of  his  trouble  led  the  patient  to  confess  that  he 
had  an  abnormal  sexual  instinct  for  his  own  sex,  that  he  was  very  pas- 
sionate, and  that  his  nervous  trouble  might  well  come  from  that.  The 
following,  taken  from  the  history  of  this  intelligent  patient,  possesses 
scientific  interest: — 

"  My  abnormal  sexual  instinct  reaches  back  to  my  childhood. 
When  three  years  old,  I  got  hold  of  a  journal  of  fashions.  The  beautiful 
pictures  of  the  men  I  kissed  until  the  paper  was  torn  to  tatters,  but  I 
paid  no  attention  to  the  female  figures.  I  did  not  like  to  play  with  boys. 
I  preferred  to  play  with  girls,  because  they  alwaj^s  had  dolls.  I  espe- 
cially liked  to  cut  out  dolls'  clothes ;  and  to-day,  in  spite  of  my  fchirty- 
three  years,  dolls  still  possess  an  interest  for  me.  When  a  boy,  for 
hours  I  would  lurk  about  available  places,  in  order  to  get  a  sight  of  male 
genitals.     When  I  succeeded,  a  strange,  dizzy  feeling  came  over  me. 


URNINGS.  263 

Weak,  unattractive  men  or  boys  made  no  impression  on  me.  At  thirteen 
I  began  to  masturbate.  From  my  thirteenth  till  my  fifteenth  year,  I 
slept  with  a  handsome  young  man.  That  was  happiness.  Hours  at  a 
time  at  night,  with  erections,  I  would  wait  for  his  return.  If  in  bed  he 
chanced  to  touch  my  genitals,  it  gave  me  delight.  At  fourteen  I  had  a 
school-mate  whose  instincts  were  like  my  own.  For  hours  at  a  time,  dur- 
ing school-hours,  we  held  each  other's  genitals.  .Ah,  those  were  happy 
hours  1  As  often  as  I  could,  I  lingered  in  bath-houses.  That  was 
always  a  feast  for  me.  The  sight  of  male  genitals  induced  violent  erec- 
tions. At  sixteen  I  came  to  the  metropolis.  Seeing  so  many  hand- 
some men  charmed  me.  In  my  eighteenth  year  I  attempted  coitus 
with  a  prostitute,  but  disgust  and  fear  made  it  impossible.  Other 
attempts  were  failures,  until  my  nineteenth  year,  when  I  tried  again 
with  success ;  but  the  act  afforded  me  no  pleasure,  rather  inducing  a 
feeling  of  disgust.  I  conquered  myself,  and  was  proud  of  my  success 
at  being  a  man,  which  I  had  gradually  begun  to  doubt. 

"  Subsequent  attempts  were  no  longer  successful.  The  disgust  was 
too  great.  When  the  woman  was  undressing,  it  became  necessary,  on 
account  of  my  feeling  of  repugnance,  to  put  out  the  light.  I  now  con- 
sidered myself  impotent,  consulted  physicians,  and  visited  baths  and 
sanitariums  to  cure  my  supposed  impotence ;  for  I  still  did  not  know 
what  to  think  of  it.  I  took  pleasure  in  the  society  of  ladies,  perhaps 
out  of  conceit ;  for  I  impressed  most  ladies  as  being  sympathetic  and 
amiable ;  but  I  valued  in  them  nothing  more  than  mental  and  aesthetic 
qualities.  I  liked  to  dance  with  them  ;  but  if  one  pressed  against  me  in 
dancing,  I  experienced  a  feeling  of  repugnance,  and  even  disgust,  and 
felt  like  striking  her.  If  in  joke  I  happened  to  dance  with  a  gentleman, 
I  always  took  the  part  of  the  lady.  I  would  press  and  rub  against  him, 
and  take  a  perfect  delight  in  it.  When  I  was  eighteen,  a  gentleman  who 
came  into  the  office,  said, '  That  is  a  fine  youth ;  in  the  East  he  would 
bring  a  pound  sterling  every  time  1 '  I  puzzled  my  head  over  that. 
Another  gentleman  liked  to  joke  with  me,  and  steal  kisses  of  me  as  he 
was  going  away,  which  I  would  have  given  him  only  too  gladly.  He 
afterward  became  my  lover.  These  circumstances  excited  my  attention, 
and  I  waited  for  an  opportunity. 

"  When  I  was  twenty-five  jrears  old,  it  happened  that  a  man  who  was 
formerly  a  Capucine  monk  became  attracted  to  me.  For  me  he  was  like 
a  Mephistopheles.  Finally  he  spoke  to  me.  To  this  day  I  can  almost 
feel  the  beating  of  my  heart  that  he  caused  me ;  I  almost  fainted.  He 
made  a  rendezvous  for  that  evening  at  a  public  house.  I  went,  but  at  the 
threshold  I  turned  back,  afraid.  On  the  next  evening  he  met  me  again. 
He  overcame  my  scruples,  and  took  me  to  his  room.  I  was  scarcely  able 
to  walk  for  excitement.  My  seducer  made  me  sit  on  his  sofa,  and,  smil- 
ing at  me,  he  fixed  his  wonderful  black  eyes  on  me,  and  I  lost  conscious- 
ness.    This  delight,  this  ideal,  divine  sense  of  pleasure  that  filled  my 


264  PSYCHOPATHIA   SEXUALlS. 

whole  being, — I  could  write  too  much  about  it.  I  think  only  an  innocent 
youth,  over  head  and  ears  in  love,  who  for  the  first  time  has  his  love's 
longing  fulfilled,  could  be  as  happy  as  I  was  that  night.  My  seducer 
demanded  my  life,  in  joke ;  but  I  at  first  thought  him  in  earnest.  I 
begged  him  to  let  me  be  happy  for  a  time,  and  then,  united  to  him,  I 
would  end  my  life.  It  would  have  been  entirely  in  accordance  with  the 
high-flown  ideas  I  entertained  at  that  time.  For  five  j'ears  after  that,  I 
kept  up  a  relation  with  the  man,  who  is  still  so  dear  to  me.  Oh,  how 
happy,  and  yet,  often,  how  unhappy,  I  was  during  those  years !  If  I  but 
saw  him  speak  to  a  handsome  young  man,  I  became  wildly  jealous. 

"When  twent3'-seven,  I  became  engaged  to  a  young  lady.  Her 
mind  and  aesthetic  feeling,  as  well  as  financial  considerations,  induced  me 
to  think  of  marriage.  At  the  same  time,  I  am  very  fond  of  children,  and, 
whenever  I  meet  even  the  commonest  day-laborer  and  his  wife  and  a 
pretty  child,  I  envy  the  man  his  good  fortune.  Thus  I  made  a  fool  of 
myself.  I  managed  to  get  through  the  time  of  courtship;  when  kissing 
my  bride  I  felt  more  anxiety  and  fear  than  pleasure.  On  one  or  two 
occasions,  however,  after  luxurious  dinners,  while  kissing  her  passion- 
ately, I  had  erections.  How  happy  I  was  at  that !  I  saw  myself  already 
a  father.  I  twice  came  near  breaking  off  the  engagement.  On  my  mar- 
riage-day, when  all  the  guests  had  assembled,  I  locked  myself  in  a  room, 
cried  like  a  child,  and  felt  that  I  could  not  proceed  with  the  ceremony. 
At  the  persuasion  of  all  the  relatives,  to  whom  I  made  the  best  excuses 
that  occurred  to  me,  I  allowed  myself  to  be  taken,  in  ordinary  street- 
costume,  to  the  altar. 

"  As  great  good  fortune  would  have  it,  at  the  time  of  the  marriage, 
my  wife  was  menstruating.  Oh,  how  thankful  I  was  for  this  excuse  ! 
I  am  now  convinced  that  this  circumstance  is  all  that  made  later  cohab- 
itation possible.  How  it  later  became  possible  for  me  to  cohabit  with 
my  wife,  and  have  a  lovety  boy,  I  do  not  know.  He  is  the  comfort  of 
my  ruined  life.  I  can  only  thank  God  for  the  happiness  of  having  a 
child.  I  was  a  cheat,  so  to  speak,  in  the  marriage-bed.  Mjr  wife,  whom 
I  respect  for  her  high  qualities  of  character,  has  no  suspicion  of  my 
condition,  but  she  often  complains  of  my  coldness.  With  her  goodness 
of  heart  and  simplicity,  it  was  possible  for  me  to  make  her  think  that 
the  conjugal  duty  should  be  performed  but  once  a  month.  Since  she  is 
in  nowise  sensual,  and  I  can  find  excuse  in  my  nervousness,  I  am 
successful  in  keeping  up  the  swindle.  Cohabitation  is  the  greatest  sac- 
rifice for  me.  By  taking  considerable  wine,  and  by  making  use  of  the  erec- 
tions which  occur  in  the  morning,  as  the  result  of  an  overfilled  bladder, 
it  is  possible  for  me  to  perform  coitus  once  a  month  ;  but  it  affords  me 
no  pleasurable  feeling,  and  I  am  worried  and  experience  an  increase  of 
my  nervous  difficulties  all  day  long  after  it.  The  consciousness  of 
having  fulfilled  my  duty  toward  ni}-  wife,  whom  in  all  other  respects  I 
love,  affords  me  moral  consolation  and  satisfaction.     With  a  man,  it  is 


URNINGS.  265 

otherwise.  With  him  I  can  perform  the  act  several  times  in  a  night, 
always  taking  the  sexual  rule  of  a  man.  In  this,  I  experience  the  great- 
est pleasure,  the  purest  happiness.  I  feel  myself  refreshed  and  invigor- 
ated Ity  it.  Of  late,  my  desire  for  men  has  somewhat  decreased ;  in 
fact,  I  have  courage  even  to  avoid  a  handsome  young  man  that 
approaches  me.  Will  it  last?  I  fear  not.  I  am  absolutely  unable  to  do 
without  male  love;  if  I  am  compelled  to  forego  it,  I  become  depressed, 
feel  weary  and  miserable,  and  have  pain  and  pressure  in  my  head.  I 
have  always  regarded  my  pitiable  peculiarity  as  something  congenital, 
and  I  would  feel  happy  if  I  had  only  not  married.  I  pity  my  good  wife. 
Often  the  fear  seizes  me  that  I  cannot  endure  it  with  her  longer;  then 
thoughts  about  divorce,  suicide,  and  flight  to  America  come  to  me." 

No  one  seeing  the  patient  to  whom  I  owe  this  communication 
would  suspect  his  condition.  His  outward  appearance  is,  in  all  respects, 
masculine  ;  he  has  a  well-developed,  full  beard,  strong  and  deep  voice,  and 
normal  genitals.  The  cranium  is  normally  formed;  signs  of  degenera- 
tion are  absolutely  wanting,  and  only  an  exquisitely  nervous  eye  makes 
one  suspect  a  neuropathic  condition.  The  vegetative  organs  perform 
their  functions  normally.  The  patient  presents  the  usual  symptoms  of 
a  neurasthenia,  which  may,  in  all  essentials,  be  ascribed  to  sexual 
excesses  with  persons  of  his  own  sex,  in  a  man  abnormally  passionate ; 
and  to  the  injurious  influences  of  forced,  though  infrequent,  coitus  with 
the  wife  where  horror  fern  in  as  exists. 

The  patient  declares  that  he  comes  from  healthy  parents,  and  that 
he  knows  of  no  neuroses  or  mental  disease  in  his  ancestry.  His  elder 
brother  was  married  three  years.  There  was  a  separation,  because  the 
husband  never  had  sexual  intercourse  with  his  wife.  He  married  a 
second  time.  The  second  wife  also  complained  of  neglect  on  the  part  of 
the  husband  ;  but  she  had  four  children,  concerning  whose  legitimacy  no 
doubt  was  ever  raised.     A  sister  is  hysteropathic. 

The  patient  says  that,  when  a  young  man,  he  suffered  with  momen- 
tary attacks  of  dizziness,  during  which  it  seemed  to  him  as  if  he  were 
about  to  die.  He  says  that  he  has  always  been  very  excitable  and 
emotional,  and  an  enthusiast  for  the  arts,  especially  poetry  and  music. 
He  himself  designates  his  character  as  enigmatical,  abnormal,  nervous, 
restless,  extravagant,  and  undecided.  He  is  often  exalted  without  real 
reason,  and  then  again  depressed,  even  to  thoughts  of  suicide.  He  may 
pass  through  quick  and  sudden  changes, — "  religious  and  frivolous, 
optimistic  and  cynical,  cowardly  and  brave,  credulous,  amiable,  and  sus- 
picious ;  inclined  to  do  others  harm,  and  sorrowful  to  tears  over  the 
misfortunes  of  others;  and  with  this, generous  to  excess, and  then  again 
miserty  a  la  Harpagon."  The  patient  is  certainly  a  tainted  individual. 
He  seems  to  be. very  well  endowed  intellectually,  and,  as  he  says,  to  have 
learned  easily,  and  been  among  the  first  at  school. 

The  marriage  of  this  man  was  not  happy.     Notwithstanding  the 


266  PSYCHOPATHIA  SEXUALlS. 

fact  that  it  was  but  very  infrequently  that  he  performed  the  inadequate 
and  injurious  sexual  act  with  his  wife,  and  that  he  sought  and  found  a 
substitute  in  male  lovers,  he  remained  neurasthenic.  His  disease,  at 
times,  presents  marked  exacerbations,  even  manifesting  itself  in  despair- 
ing depression  about  his  matrimonial,  sexual,  and  mental  condition, 
which  even  extends  to  violent  taadium  vitae. 

His  wife  became  hysteropathic  and  anaemic, and  the  patient  attributed 
this  to  sexual  abstinence.  Try  as  he  would  to  force  himself,  of  late  years 
he  has  not  been  able  to  perform  coitus,  erection  failing  completely ; 
while,  in  intercourse  with  male  lovers,  he  is  very  potent. 

The  son  of  these  unfortunate  parents,  who  is  now  over  nine  years 
old,  develops  well.  The  patient  adds  that  formerly,  in  coitus  with  his 
wife,  he  was  potent  only  when  he  thought  of  a  beloved  man.  (From  the 
author's  "  Lehrb.  der  Psychiatric'') 

Case  114.  Autobiography.  "  The  writer  of  this  is  a  congenital 
urning.  If  I  have  not  consorted  with  other  urnings,  nevertheless,  I  am 
fully  informed  of  my  condition  ;  for  it  has  been  my  lot  to  see  almost  all 
literature  on  the  subject.  A  short  time  ago,  j-our  work, '  Psychopathia 
Sexualis.'  was  sent  to  me.  I  saw  in  it  that  you  were  working  and  study- 
ing without  prejudice  in  the  interest  of  science  and  humanity. 

"  If  I  cannot  tell  you  much  that  is  new,  yet  I  will  speak  of  a  few 
things  which  I  trust  }Tou  will  receive  as  one  more  stone  to  be  used  by 
you  in  your  work ;  which,  I  am  confident,  will,  in  your  hands,  aid  in 
saving  us. 

"  When  you  presume  that  there  is  often  an  hereditary  tainted  con- 
dition, perhaps  jo\\  are  right.  My  father  was  subject  to  spinal  disease 
before  my  birth  ;  later,  lie  became  mentally  unsound,  and  took  his  own  life. 

"  Another  point,  which  I  am  inclined  to  doubt,  is  the  one  mentioned 
by  you  in  another  place, — i.e.,  that  onanism  practiced  from  youth  may 
lead  to  perverse  instinct. 

"  I  (merchant,  owner  of  a  small  business,  unmarried)  am  in  the  be- 
ginning of  my  thirtieth  year.  I  am  apparently  healthy,  and  show  scarcely 
a  deviation  from  the  normal  masculine  t}Tpe.  The  first  sexual  impulses 
were  immediately  and  exclusively  directed  to  the  male  sex,  and  I  experi- 
enced them  from  my  tenth  year.  I  have  masturbated  since  my  twelfth 
year.  Since,  in  spite  of  all  attempts,  coitus  with  women  was  alwa3*s 
absolutely  impossible  for  me ;  and  since  I  have  never  had  desire  for 
women — on  the  contrary,  rather  aversion ;  and  since  my  attempts  have 
never  resulted  in  the  slightest  erection,  I  have  been  compelled  to  satisfy 
myself  by  onanism. 

"If  now  I  am  to  confess  the  manner  of  my  sexual  satisfaction,  I 
may  sa}r  that  in  m}r  earlier  jears  my  fellow-pupils  and  companions  ex- 
cited me  sexually.  Now  my  impulse  consists  in  a  desire  for  boys  of 
about  ten,  but  mostly  for  youths  of  from  fifteen  to  twenty  years. 

"  For  a  long  time,  strong  and  healthy  cadets,  of  fine  form,  have  had 


ttRNlNGS.  367 

a  particular  charm  for  me  ;  and  by  their  handsome  uniforms  and  fine  pres- 
ence they  especially  excite  niy  desire.  I  have  no  opportunity  to  approach 
them,  or  even  to  enter  into  distant  social  intercourse  with  them  ;  but  I  am 
compelled  to  satisfy  myself  with  following  them  in  the  streets  and 
squares  ;  or  in  restaurants,  horse-Cars  or  railways,  by  sitting  near  them, 
and,  when  it  is  possible  to  do  it  unnoticed,  under  such  circumstances, 
by  practicing  onanism.  My  most  ardent  wish  has  often  been  to  become 
the  friend,  servant,  or  slave  of  such  a  young  man. 

"  I  have  never  even  dreamed  of  direct  pedei'asty ;  my  desire  has 
alwa}-s  been  bodily  contact,  embrace,  manustupration  of  my  genitals  by 
my  lover,  and,  on  my  part,  a  kiss  on  his  genitals  or  podex^ 

"  I  often  have  the  desire,  however,  to  represent  Sacher-Masoch  in 
his  '  Venus  in  Furs.'  There  a  man  makes  himself  the  voluntary  slave 
of  a  woman,  and  feels  an  intense  thrill  of  lustful  pleasure,  if  he  is  only 
chastised  and  humiliated  by  her.  But  I  naturally  feel  that  I  could,  under 
no  circumstances,  become  the  slave  of  a  woman,  but  only  of  a  man  ;  more 
correctly,  of  a  young  man  ;  one,  however,  for  whom  I  should  have  such 
an  infinite  love  that  I  could  give  myself  up  entirely  to  his  mercy  or 
cruelty. 

"  The  lustful  images  that  float  before  my  mind  in  masturbation  are 
those  of  this  or  that  young  man  that  I  have  just  seen.  As  a  sad  and 
incomplete  substitute,  I  practice  this  onanism  constantly. 

"  I  pass  into  a  lustful  dream  in  this  way  (and  I  say  all  here,  because 
I  wish  to  write  only  the  truth  and  the  whole  truth) :  I  choose  a  young 
man  that  pleases  me  by  his  form,  and  in  imagination  give  myself  up  to 
involuntary  obedience  to  him.  I  imagine  that  he  wishes  to  humiliate  me, 
and  that  he  commands  me,  for  example,  to  kiss  his  feet;  or  compels  me 
to  smell  his  socks.  For  want  of  the  desired  actuality,  I  take  my  own 
socks,  smell  of  them,  take  them  into  my  mouth,  rub  them  over  my  geni- 
tals, and  immediately  erection  and  ejaculation,  with  sensual  pleasure, 
take  place. 

"  Yes,  I  am  so  dominated  by  this  mental  imagery  that  I  imagine 
that  the  young  man  is  my  confessor,  and,  in  order  to  humiliate  me,  orders 
me  to  eat  of  his  excrement.  Here  again,  in  want  of  actuality,  I  eat  of 
my  own  excrement,  but  only  in  small  quantity.  Then,  with  an  imperfect 
feeling  of  disgust  and  violent  palpitation  of  the  heart,  erection  and 
ejaculation  take  place. 

"  However,  I  come  to  this  vile,  feverish  imagery  and  the  perform- 
ance of  these  acts,  only  when  it  has  not  been  possible  for  me  for  a  long 
time  to  satisfy  nvyself  by  onanism  in  the  immediate  vicinity  of  a  young 
man. 

"  This  is  for  me  more  natural,  because  I  then  have  more  pleasure,  and 
experience  a  more  perfect  physical  and  mental  benefit,  even  though  my 
ideal  of  actual  and  direct  satisfaction  in  mutual  understanding  were 
never  to  be  accorded  me. 


268  PSYCHOPATHIA   SEXUALIS. 

"  I  almost  believe  that  the  above-mentioned  disgusting  imagery  is 
only  the  evil  result  of  constant  want  of  normal  satisfaction, — i.e.,  of  my 
normal  satisfaction  as  an  urning ;  and  that  with  a  regular  satisfaction, 
body  to  body,  the  imagery  that  becomes  almost  insane  would  be  less 
intense,  and  certainly  would  not  go  to  such  extravagance.  Or  it  is  the 
ultimate  result  of  an  attempt  at  abstinence  ;  for  these  idiotic,  sensual 
images  only  come  after  a  long  period  of  it. 

"  I  believe,  indeed,  that,  under  other  social  conditions,  I  should  be 
capable  of  great  and  noble  love  and  self-sacrifice.  My  thoughts  are  in 
no  way  exclusively  carnal  or  diseased.  How  often,  at  the  sight  of  a 
handsome  young  man,  a  deep  feeling  of  impatience  seizes  me,  and  I 
breathe  at  once  the  sweet  words  of  Heine  : — 

"  '  Du  bist  wie  eine  Blume,  so  hold,  so  schdn,  so  rein,'  etc.1 

"  And  once,  when  I  was  compelled  to  part  with  a  3*oung  man  who 
had  honored  and  valued  me  as  his  friend  and  protector,  though  my  love 
had  remained  unknown  to  him,  those  fine  verses  by  Scheffel  kept  passing 
through  my  mind,  especially  the  last, — mutatis  mutandis : — 

"  •  Grau  wie  der  Himmel,  steht  vor  mir  die  Welt, 
Doch  wend'  es  sich  zum  Guten  oder  Bosen, 
Du,  lieber  Freund,  in  Treuen  denk'  ich  Dein  ! 
Behiit  Dich  Gott  I  es  war'  zu  schon  gewesen, 
Behiit  Dich  Gott,  es  hat  nicht  sollen  sein  !  '2 

"  I  have  never  independently  revealed  my  love  to  a  young  man,  and 
have  never  spoiled  or  injured  one  morally;  but  I  have,  now  and  then, 
made  the  way  easy  for  many.  Under  such  circumstances,  nothing  is  too 
much  trouble,  and  I  obtain  victims  as  only  I  can. 

"  When  I  have  an  opportunity  to  have  such  a  beloved  friend  about 
me,  to  educate,  protect,  and  help,  if  my  recognized  love  find  a  (natural, 
unsexual)  return,  then  all  my  disgusting  mental  imagery  grows  less  and 
less  intense ;  then  my  love  becomes  almost  platonic  and  ennobled,  to  sink 
again  into  the  mire  when  this  worthy  satisfaction  is  removed. 

"  As  for  the  rest,  and  without  over-estimating  myself,  I  may  say 
that  I  am  not  one  of  the  worst  of  men.  Brighter  mentally  than  the 
average  man,  I  take  interest  in  all  that  moves  humanity.  I  am  amiable, 
and  easily  moved  to  pity,  and  am  incapable  of  doing  any  animal,  much 
less  a  man,  an  injury ;  but,  on  the  contrary,  do  good  wherever  I  can. 

"  When  I  have  nothing  to  reproach  myself  with  in  my  own  con- 
science, and  must,  at  the  same  time,  set  myself  in  opposition  to  the 

1  "  Thou  art  like  any  flower,  so  sweet,  so  beautiful,  so  pure,"  etc. 

2  "  Lowering  like  the  heavens,  frowns  the  world  on  me, 

Yet  blest  or  cursed  will  be  the  fate  I  meet. 
With  trusting  heart,  dear  friend,  I  think  of  thee  ! 
God  keep  thee,  dear  !  it  would  have  been  too  sweet ! 
God  keep  thee,  dear  I  such  happiness  was  not  to  be  J" 


URNINGS.  269 

judgment  of  the  world,  I  suffer  very  much.  Indeed,  I  have  done  no 
one  harm,  and  I  consider  my  love,  in  its  noblest  activity,  to  be  quite  as 
holjT  as  that  of  a  normal  man  ;  but,  with  the  unhappy  lot  which  impa- 
tience and  ignorance  cast  upon  us,  I  suffer  even  to  the  extent  of  tsedium 

vitse.Sj^ 

"No  pen,  no  tongue  can  describe  all  the  misery,  all  the  unhappy 
situations,  the  constant  fear  of  having  this  peculiarity  recognized,  and 
of  being  cast  from  society.  The  one  thought  that,  as  soon  as  recognized, 
one's  existence  would  be  lost,  and  he  would  be  cast  away  from  all,  is  as 
terrible  as  any  thought  can  be.  Then  all  the  good  that  one  had  ever 
done  would  be  forgotten  ;  then,  in  the  pride  of  his  great  morality,  every 
normal  man  would  be  moved  to  scorn,  even  though  he  himself  had  been 
never  so  frivolous  in  his  own  love. 

"Then  what  does  our  misery  amount  to?  We  may,  cursing  man, 
end  our  unhappy  lives.  Truly,  I  often  long  for  the  quiet  of  an  asylum. 
My  life  may  end  when  it  will,  the  quicker  the  better;  I  am  ready. 

"  To  refer  to  one  more  point :  I  also  believe,  like  the  others  that 
have  written  to  you,  that  our  nervousness  is  first  acquired  as  a  result" 
of  our  unhappy,  unspeakably  miserable  life  among  our  fellow-creatures. 

"  And  still  another :  You  write,  at  the  conclusion  of  your  work, 
concerning  the  repeal  of  the  legal  enactments  concerned.  Indeed, 
humanity  would  not  be  destroyed  if  they  were  repealed.  In  Italy  there 
is  no  such  law,  as  far  as  I  know ;  and  Italy  is  not  a  wilderness,  but  a 
cultivated  nation. 

"  As  for  myself,  compelled  as  I  am  to  undermine  my  life  by  onan- 
ism, the  law.  could  not  touch  me ;  for  I  have  never  sinned  against  it  in  a 
letter.  But,  at  the  same  time,  I  suffer  under  the  accursed  scorn  to 
which  we  are  subjected.  How  can  the  ideas  of  society  be  changed,  so 
long  as  there  is  a  law  which  strengthens  it  in  its  immorality?  The  law 
must,  of  course,  correspond  with  public  opinion;  but  it  should  not  be  in 
harmony  with  the  erroneous  opinion  of  ignorance,  but  only  in  accord 
with  the  ideas  of  the  best  and  most  scientific  thinkers, — not  with  the 
wish  and  prejudice  of  the  vulgar.  True  thinking  minds  cannot  much 
longer  be  satisfied  with  the  old  idea. 

"  Pardon  me,  Professor,  if  I  close  without  a  signature.  Do  not 
try  to  find  me.  I  could  tell  jrou  nothing  more.  I  give  you  these  lines 
in  the  interest  of  future  sufferers.  Publish  from  them,  in  the  interest 
of  science,  truth,  and  justice,  what  seems  to  you  to  be  necessary." 

Case  115.  On  a  summer  evening,  at  twilight,  X.  Y.,  a  physician  of 
a  city  in  North  Germany,  was  detected  by  a  watchman  while  committing 
a  misdemeanor  with  a  countryman  in  a  field.  He  was  practicing  mastur- 
bation on  him,  and  then  mentulam  alius  in  os  suum  immisit.  X.  escaped 
legal  prosecution  by  flight.  The  authorities  dismissed  the  complaint, 
because  there  had  been  no  publicity,  and  because  immissio  membri  in 
anum  had  not  taken  place.     Among  X.'s  effects  was  found  an  extensive 


270  PSYCHOPATHIA  SEXUALIS. 

correspondence  of  a  perverse  sexual  character,  which  showed  that  he 
had  had  perverse  intercourse  for  years  with  all  classes  of  people. 

X.  came  of  a  neurotic  family.  His  paternal  grandfather  died  by 
suicide  while  insane.  His  father  was  a  weak,  peculiar  man.  One  brother 
masturbated  at  the  age  of  two.  A  cousin  was  sexually  perverse,  and 
practiced  perverse  acts,  similar  to  those  of  X.,  while  a  youth ;  he  became 
weak-minded,  and  died  of  spinal  disease.  A  paternal  great-uncle  was  an 
hermaphrodite.  His  mother's  sister  was  insane.  His  mother  is  said  to 
have  been  healthy.     X.'s  brother  is  nervous  and  irascible. 

X.,  likewise,  was  nervous  as  a  child.  The  mewing  of  a  cat  would 
create  great  fear  in  him  ;  and  if  one  but  imitated  the  voice  of  a  cat,  he 
would  cry  bitterly,  and  run  to  others  for  protection.  Slight  phjrsical  dis- 
turbance caused  violent  fever.  He  was  a  quiet,  dreamy  child,  of  excita- 
ble imagination,  but  of  slight  mental  capabilities.  He  did  not  indulge 
much  in  boyish  games ;  he  preferred  feminine  pursuits.  It  gave  him 
especial  pleasure  to  curl  the  hair  of  the  house-maid  or  of  his  brother. 

At  thirteen  X.  went  to  an  Institute.  There  he  practiced  mutual 
masturbation,  seduced  his  comrades,  and,  by  his  cynical  conduct,  made 
them  unmanageable ;  so  that  he  had  to  be  taken  home.  At  that  time 
the  parents  found  love-letters  with  lascivious  contents,  showing  perverse 
sexuality.  From  the  age  of  seventeen  he  studied  under  the  strict  sur- 
veillance of  a  professor  in  a  Gymnasium.  He  made  but  sad  progress  in 
learning.     He  had  only  a  talent  for  music. 

After  finishing  his  studies,  the  patient  entered  the  Universit}',  at 
the  age  of  nineteen.  There  he  attracted  attention  by  his  cynical  charac- 
ter and  his  association  with  young  persons  who  were  thought  to  be  given 
to  masculine  love.  He  began  to  be  dandified;  wore  striking  cravats, and 
shirts  that  were  low  cut ;  he  forced  his  feet  into  narrow  shoes,  and  curled 
his  hair  in  a  remarkable  way.  This  peculiarity  disappeared  when  he  left 
the  school,  and  had  returned  home. 

At  the  age  of  twenty-four  he  was  for  a  long  time  neurasthenic. 
From  that  time  until  his  twenty  -ninth  year,  he  was  earnest  and  skill- 
ful in  his  profession  ;  but  he  avoided  the  society  of  the  opposite  sex,  and 
constantly  associated  with  men  of  doubtful  character. 

The  patient  would  not  allow  a  personal  examination.  In  writing, 
he  made  the  excuse  for  this  that  it  would  be  of  no  use,  because  his 
impulse  to  his  own  sex  had  existed  from  his  earliest  childhood,  and  was 
congenital.  He  had  always  had  horror  feinime,  and  had  never  been 
inclined  to  avail  himself  of  the  charms  of  women.  Toward  men  he  felt 
himself  in  the  role  of  a  man.  He  recognized  his  impulse  toward  his  own 
sex  as  abnormal,  and  excused  his  sexual  indulgence  as  being  the  result 
of  an  abnormal  natural  condition. 

Since  his  flight  X.  lives  out  of  German37,in  Southern  Italy,  and,  as 
I  learned  from  a  letter,  now,  as  before,  he  indulges  in  perverse  love.  X. 
is  an  earnest,  stately  man,  of  masculine  features,  well-grown  beard,  and 


URNINGS.  271 

normally  developed  genitals.  Dr.  X.  furnished  me,  a  short  time  ago, 
with  his  autobiography,  of  which  the  following  is  worthy  of  mention : — 

"  When,  at  the  age  of  seven,  I  entered  the  private  school,  I  felt 
very  uncomfortable,  and  found  very  little  sympathy  with  my  companions. 
Only  toward  one  of  them,  who  was  a  very  handsome  child,  did  I  feel 
attracted,  and  I  loved  him  wildly.  In  childish  games  I  always  knew 
how  to  arrange  it  so  that  I  could  appear  in  feminine  attire ;  and  my 
greatest  pleasure  was  to  form  intricate  coiffures  for  our  servant-girls.  I 
often  regretted  that  I  was  not  a  girl. 

"  My  sexual  instinct  awakened  when  I  was  thirteen,  and  from  the 
moment  of  its  appearance  was  directed  toward  youthful,  strong  men. 
At  first  I  was  not  really  certain  that  this  was  abnormal,  but  conscious- 
ness of  it  came  when  I  saw  and  heard  how  my  companions  were  charac- 
terized sexually.  I  began  to  masturbate  at  the  age  of  thirteen.  At 
seventeen  I  left  home  and  went  to  the  Gymnasium  of  a  large  Capital, 
where  I  was  put  to  board  with  a  married  professor  of  the  Gymnasium, 
with  whose  son  I  afterward  had  sexual  relations.  It  w7as  with  him  that 
I  first  had  sexual  satisfaction.  Thereafter  I  made  the  acquaintance  of  a 
young  artist,  who  very  soon  noticed  that  I  was  abnormal,  and  confessed 
to  me  that  he  was  in  the  same  condition.  I  learned  from  him  that  this 
abnormality  was  very  frequent ;  and  this  knowledge  overcame  the  trouble 
that  I  had  had  in  supposing  that  I  was  alone  in  my  abnormality.  This 
young  man  had  an  extensive  acquaintance  with  persons  in  like  condi- 
tion, to  which  he  introduced  me.  There  I  became  the  object  of  general 
attention,  for  on  all  sides  I  was  declared  to  be  very  attractive  physically. 
I  soon  became  insaneby  loved  by  an  old  gentleman;  but,  not  finding  him 
to  my  taste,  I  endured  him  but  a  short  time,  and  then  gave  ear  to  a 
young  and  handsome  officer  who  lay  at  my  feet.  He  was  really  my 
first  love. 

"  After  passing  my  final  examination,  at  the  age  of  nineteen,  free 
from  the  discipline  of  school,  I  made  the  acquaintance  of  a  great  number 
of  people  like  myself,  and  among  them  Karl  Ulrichs  (Numa  Numan- 
tinus). 

"  When,  later,  I  took  up  the  study  of  medicine,  and  associated  with 
many  normal  youths,  I  was  often  in  a  position  where  I  was  compelled  to 
visit  public  prostitutes.  After  having  consorted  to  no  purpose  with 
various  prostitutes,  some  of  whom  were  very  beautiful,  the  opinion  was 
spread  among  my  acquaintances  that  I  was  impotent,  and  I  strengthened 
this  by  telling  of  previous  sexual  excesses.  At  that  time  I  had  numerous 
external  relations  with"  persons  who  prized  my  physical  peculiarities, 
which  were  considered  very  beautiful.  The  result  of  this  was,  that  I  was 
exciting  somebody  all  the  time ;  and  I  received  such  a  mass  of  love-letters 
that  I  was  often  in  embarrassment.  The  acme  of  this  was  reached  later, 
when,  as  a  physician,  I  lived  in  the  hospital.  There  I  moved  about  like 
a  celebrated  person,  and  the  scenes  of  jealousy  that  took  place,  on  my 


272  PSYCHOPATHIA   SEXUALIS. 

account,  almost  led  to  the  discovery  of  the  whole  thing.  Shortly  after 
this,  I  fell  ill  with  an  inflammation  of  my  shoulder-joint,  from  which  I 
recovered  after  three  months.  During  this  illness  I  received  subcu- 
taneous injections  of  morphine  several  times  daily,  which  were  suddenly 
discontinued,  and  which  I  practiced  thereafter  secretly  after  my  recovery. 
For  the  purpose  of  special  study,  I  spent  some  months  in  Vienna,  before 
entering  into  private  practice,  and  there,  by  means  of  some  recommenda- 
tions, I  gained  entrance  to  various  circles  of  people  like  myself.  I  there 
learned  that  the  abnormality  in  question,  in  its  various  forms,  is  spread 
through  the  lower  classes  as  well  as  the  higher,  and  that  those  who  are 
approachable  for  money  are  not  infrequently  met  among  the  higher 
classes,  tf 

"  W  hen  I  established  myself  in  the  country,  I  hoped  to  cure  myself 
of  the  morphine  habit  by  means  of  cocaine  ;  and  then  I  became  a  victim 
of  cocaine,  which,  only  after  three  relapses,  I  was  able  to  rid  myself  of 
(about  two  years  ago).  In  my  position,  it  was  impossible  for  me  to  find 
sexual  satisfaction,  and  I  noticed  with  pleasure  that  the  use  of  cocaine 
had  overcome  my  desire.  When,  on  the  first  occasion,  at  the  urgent 
request  of  my  aunt,  I  had  emancipated  myself  from  cocaine,  I  traveled 
for  a  few  weeks,  in  order  to  improve  my  health,  the  perverse  impulses 
were  again  awakened  in  their  old  strength,  and,  one  evening,  while  out  in 
the  fields  by  the  city  amusing  myself  with  a  man,  I  noticed  that  I  had 
been  detected  by  the  authorities  and  advertised ;  but  that  the  act  of  which 
I  was  accused  was  not  punishable,  in  accordance  with  the  opinion  ex- 
pressed by  the  highest  court  of  the  German  kingdom.  I  had,  therefore, 
to  be  careful ;  for  already  the  announcement  of  the  crime  had  been  heralded 
on  all  sides.  I  saw  that,  after  this,  I  would  be  compelled  to  leave  Germany, 
and  find  a  new  home  where  neither  the  law  nor  public  opinion  would  be 
opposed  to  that  impulse,  which,  like  all  abnormal  instincts,  could  not  be 
overcome  by  the  will.  Since  I  was  never  deceived  for  a  moment  about 
the  matter,  in  recognizing  my  impulses  as  opposed  to  social  "usages,  I 
repeatedly  attempted  to  become  master  of  them ;  but  by  these  efforts  they 
were  increased  in  power.  This  same  observation  has  been  communicated 
to  me  by  acquaintances.  Since  T  was  exclusively  drawn  toward  strong, 
youthful,  and  masculine  individuals,  and  they  were  very  seldom  inclined 
to  yield  to  my  wishes,  I  was  compelled  to  buy  them.  Since  my  desire 
was  limited  to  persons  of  the  lower  classes,  I  was  always  able  to  find 
such  as  were  purchasable  with  money.  I  hope  that  the  following  state- 
ments will  not  awaken  your  repugnance.  At  first  I  intended  to  omit 
them ;  but,  for  the  completeness  of  this  communication,  I  may  include 
them,  since  they  serve  to  enrich  the  clinical  material.  I  am  compelled 
to  perform  the  sexual  act  in  the  following  way  : — 

"  Pene  juvenis  in  os  recepto,  ita  ut  commovendo  ore  meo  effecerim, 
ut  is  quem  cupio,  semen  ejaculaverit,  sperma  in  perinaeum  exspuo,  femora 
comprimi  jubeo  et  penem  meum  ad  versus  et  intra  femora  compressa 


URNINGS.  273 

imraitto.  Dum  haec  fiunt,  necesse  est,  ut  juvenis  me,  quantum  potest, 
amplectatur.  Quae  prius  me  fecisse  narravi,  eandem  mihi  afferunt  volup- 
tatem,  acsi  ipse  ejaculo.  Ejaculationem  pene  in  anum  immittendo  vel 
manu  terendo  assequi,  mihi  nequaquam  amoenum  est. 

"  Sed  inveni,  qui  penem  meum  receperint  atque  ea  facientes,  quae 
supra  exposui,  effecerint,  ut  libidines  meae  plane  sint  saturatae. 

"  Concerning  my  person,  I  must  still  mention  the  following :  I  am 
186  centimetres  tall,  of  masculine  appearance,  and,  with  the  exception  of 
abnormal  irritability  of  the  skin,  healthy.  My  hair  and  beard  are  black 
and  thick.  My  genitals  are  of  medium  size  and  normally  formed.  I 
am  able,  without  any  trace  of  fatigue,  to  perform  the  sexual  act  from  four 
to  six  times  in  twenty-four  hours.  My  life  is  very  regular.  I  use  alcohol 
and  tobacco  very  sparingly.  I  play  the  piano  quite  well,  and  some  of 
my  unpretentious  compositions  have  been  much  applauded.  I  have 
lately  finished  a  novel,  which,  as  my  first  work,  has  been  very  favorably 
criticised  by  my  friends.  The  story  has  several  problems  taken  from  the 
life  of  urnings  in  the  subject-matter. 

"Among  the  large  number  of  fellow-sufferers  that  are  personally 
known  to  me,  I  have  naturally  been  in  a  position  to  make  observations 
concerning  the  condition  and  the  degrees  of  abnormality ;  and,  perhaps, 
the  following  communications  may  be  of  service  to  you  : — 

"  The  most  abnormal  thing  that  I  am  acquainted  with,  was  the 
impulse  of  a  gentleman  who  lived  in  Berlin.  He  preferred,  above  all 
others,  young  fellows  with  unwashed  feet,  which  he  would  lick  passion- 
ately. A  gentleman  in  Leipzig  was  similar  to  him ;  who,  where  it  was 
possible,  would  linguam  in  anum  immittere,  preferring  the  parts  to  be 
uncleaned.  Several  have  assured  me  that  the  sight  of  riding-boots  or  of 
parts  of  military  uniforms,  induced  such  excitement  in  them  that  ejacula- 
tion resulted.     A  man  in  Paris  compelled  a  friend  ut  in  os  ei  mingat. 

"  With  reference  to  the  degree  in  which  many  feel  themselves  as 
women,  which  is  with  me  not  the  case,  two  persons  in  Vienna  are  ex- 
amples. They  bore  feminine  names.  One  is  a  barber  who  calls  himself 
'French  Laura';  the  other  was  formerly  a  butcher,  who  calls  himself 
1  Selcher-Fanny.'  Both  of  them  never  missed  an  opportunity,  during  the 
carnival  time,  to  show  themselves  in  very  fantastic  feminine  masks.  In 
Hamburg  there  is  a  person  that  many  people  believe  to  be  a  woman,  be- 
cause he  alwa3rs  goes  about  the  house  in  feminine  attire,  and  only  occa- 
sionally leaves  the  house,  and  always  in  such  clothing  This  man  wished 
to  stand  as  godmother  at  a  christening,-  and,  as  a  result  of  it,  gave  rise  to 
great  scandal. 

"  Feminine  timidit}7,  frivolity,  obstinacy,  and  weakness  of  character, 
are  the  rule  in  such  individuals. 

"  Several  cases  of  perverse  sexuality  are  known  to  me  where  epilepsy 
and  psychoses  are  present.  Hernias  are  remarkably  frequent.  In  prac- 
tice many  persons  come  to  me  to  be  treated  for  diseases  of  the  anus, 

18 


274  PSYCHOPATHIA   SEXUALIS.. 

because  of  recommendation  by  friends.  I  saw  two  syphilitic  and  one 
local  chancre,  and  several  fissures ;  and  at  present  I  am  treating  a 
gentleman  for  condylomata  of  the  anus,  which  form  a  rounded  tumor  as 
large  as  a  fist.  One  case  of  primary  affection  of  the  soft  palate  I  saw  in 
Vienna,  in  a  young  man  who  was  accustomed  to  frequent  mask-balls 
dressed  as  a  girl,  and  entice  young  men ;  he  would  then  pretend  that  he 
was  menstruating,  and  thus  induce  the  others  to  use  him  per  os.  The 
assertion  was  made  that  in  this  way  he  had  deceived  fourteen  men  in  one 
evening.  Since,  in  none  of  the  publications  concerning  contrary  sexuality 
that  I  have  seen,  I  have  found  anything  concerning  the  intercourse  of 
pederasts  among  themselves,  I  venture  to  communicate  something  con- 
cerning it  in  conclusion  : — 

"  As  soon  as  individuals  that  are  affected  with  contrary  sexuality 
become  acquainted,  there  is  a  detailed  narration  of  their  experiences, 
loves,  and  seductions,  as  far  as  the  social  difference  between  them  allows 
such  entertainment.  Only  in  very  few  cases  is  this  amusement  uncom- 
mon with  new  acquaintances.  Among  themselves,  they  call  themselves 
1  aunts  ' ;  in  Vienna, '  sisters  ' ;  and  two  very  masculine  public  prostitutes 
in  Vienna,  whom  I  accidentally  became  acquainted  with,  and  who  lived 
in  a  perverse  sexual  relation  with  each  other,  told  me  that  for  the  cor- 
responding condition  in  women  the  name  '  uncle  '  was  used.  Since  be- 
coming conscious  of  my  abnormal  instinct,  I  have  met  thousands  of  such 
individuals. 

"  Almost  every  large  city  has  some  meeting-place,  as  well  as 
a  so-called  promenade.  In  smaller  cities  there  are  relativeljr  few  '  aunts,' 
though  in  a  small  town  of  2300  inhabitants  I  found  eight,  and  in  one  of 
7000  eighteen  of  whom  I  was  absolutely  sure, — to  say  nothing  of  those 
whom  I  suspected.  In  my  own  town  of  30,000  inhabitants,  I  personally 
know  about  one  hundred  and  twenty  '  aunts.'  The  greater  number  of 
them,  and  I  especially,  possess  the  capability  of  judging  another  imme- 
diately as  to  whether  they  are  alike  or  not,  which,  in  the  language  of  the 
1  aunts,'  is  called  '  reasonable  '  or  '  unreasonable.'  My  acquaintances  are 
often  astounded  at  the  certainty  of  m}'  judgment.  Individuals  that  are 
apparently  absolutely  masculine  I  recognize  as  '  aunts '  at  the  first 
sight.  On  the  other  hand,  I  am  able  to  behave  myself  in  such  a  mascu- 
line way  that,  in  circles  to  which  I  have  been  introduced  by  acquaintances, 
there  is  a  doubt  as  to  my  genuineness.  When  I  am  in  the  mood,  I  can 
act  exactly  like  a  girl. 

"  Since  the  majority  of  '  aunts,'  like  myself,  in  no  wa}'  regret  their 
abnormalit}',  but  would  be  sorry  if  the  condition  were  to  be  changed ; 
and,  moreover,  since  the  congenital  condition,  according  to  my  own  and 
all  other  experience,  cannot  be  influenced  ;  therefore,  all  our  hope  rests 
upon  the  possibility  of  a  change  of  the  laws  with  reference  to  it,  so  that 
only  rape  or  the  commission  of  public  offense,  when  this  can  be  proved 
at  the  same  time,  shall  be  punishable." 


URNINGS.  275 

Case  116.  Contrary  Sexual  Instinct  in  a  Woman. — S.  J.,  aged  38, 
governess,  came  to  me  for  advice  about  a  nervous  trouble.  Her  father 
was  temporarily  insane,  and  died  of  a  brain  disease.  The  patient  is  an 
only  child,  and  even  when  quite  young  she  suffered  with  feelings  of 
anxiety  and  painful  ideas.  She  thought,  for  example,  that  she  would 
awake  in  her  coffin  after  it  had  been  closed  ;  that  at  confession  she 
might  forget  something,  and  make  a  sinful  confession.  She  suffered 
much  with  headache.  She  was  always  very  much  excited  and  appre- 
hensive, but  yet  she  had  to  see  horrible  things,  like  corpses,  etc. 

Even  in  her  earliest  childhood,  the  patient  was  excited  sexually, 
and  began  to  masturbate  without  any  teaching.  The  menses  began  at 
fourteen,  and  were  always  accompanied  by  colicky  pains,  violent  sexual 
excitement,  migraine,  and  depression.  After  her  eighteenth  year  she 
learned  to  repress  her  impulse  to  masturbate. 

The  patient  has  never  felt  any  inclination  toward  persons  of  the 
opposite  sex.  If  she  thought  of  marriage,  it  was  only  because  she 
sought  in  matrimony  a  means  of  being  supported.  On  the  other  hand, 
she  felt  powerfully  attracted  by  girls.  At  first  she  regarded  this  inclina- 
tion as  friendship ;  but  in  the  depth  of  her  attachment  to  female  friends, 
and  in  the  longing  she  constantly  felt  for  them,  she  recognized  that  the 
feeling  was  something  more  than  friendship. 

The  patient  cannot  understand  how  a  girl  can  love  a  man,  but  she 
can  easil}'  see  how  a  man  might  love  a  girl.  She  always  has  a  lively 
interest  in  beautiful  women  and  girls,  and  is  powerfully  excited  at  sight 
of  them.  Her  longing  had  always  been  to  kiss  and  embrace  such  dear 
creatures.  She  had  never  dreamed  of  a  man,  but  only  of  girls.  Her 
delight  had  been  to  revel  in  the  sight  of  them.  Separation  from  such 
female  friends  had  always  made  her  desperate. 

The  patient,  whose  appearance  is  perfectly  feminine  and  very 
respectable,  states  that  she  has  never  felt  herself  in  any  particular  role 
with  her  friends,  not  even  in  dreams.  Female  pelvis;  large  mammae;  no 
sign  of  beard. 

Case  117.  Mrs.  R.,  Russian,  aged  35,  of  high  social  position,  was 
brought  to  me,  in  1886,  by  her  husband  for  advice. 

Father  was  a  physician,  and  very  neuropathic.  Paternal  grand- 
father was  healthy  and  normal,  and  reached  the  age  of  ninety-six.  Facts 
concerning  paternal  grandmother  are  wanting.  All  the  children  of 
father's  family  are  said  to  have  been  nervous.  The  patient's  mother 
was  nervous,  and  suffered  with  asthma.  The  mother's  parents  were 
healthy.     One  of  the  mother's  sisters  had  melancholia. 

From  her  tenth  year  patient  has  been  subject  to  habitual  headache. 
With  the  exception  of  measles,  she  has  had  no  illness.  She  was  capable, 
and  enjoyed  the  best  of  training,  having  especial  talent  for  music  and 
languages.  It  became  necessary  for  her  to  prepare  herself  for  the  work  of 
a  governess,  and  during  her  earlier  years  she  was  mentally  overworked. 


276  PSYCHOPATHIA   SEXUALIS. 

She  passed  through  an  attack  of  melancholia  sine  delirio,  of  some 
months'  duration,  at  seventeen.  The  patient  asserts  that  she  has  always 
had  sympathy  only  for  her  own  sex,  and  found  only  an  aesthetic  interest 
in  men.  She  never  had  any  taste  for  female  work.  As  a  little  girl,  she 
preferred  to  play  with  boys. 

She  says  she  remained  well  until  her  twenty-seventh  year.  Then, 
without  external  cause,  she  became  depressed  and  considered  herself  a  bad, 
sinful  person,  had  no  pleasure  in  anything,  and  was  sleepless.  During 
this  time  of  illness  she  was  also  troubled  with  imperative  conceptions : 
that  she  must  think  of  the  death  of  herself  and  her  relatives.  Recovery 
after  about  five  months.  She  then  became  a  governess,  was  overworked, 
but  remained  well,  except  for  occasional  neurasthenic  symptoms  and 
spinal  irritation. 

At  twenty -eight  she  made  the  acquaintance  of  a  lady  five  years 
3^ounger  than  herself.  She  fell  in  love  with  her,  and  her  love  was 
returned.  The  love  was  very  sensual,  and  satisfied  by  mutual  mastur- 
bation. "I  loved  her  as  a  god  ;  her's  is  a  noble  soul,"  she  said,  when  she 
mentioned  this  love-bond.  It  lasted  four  years,  and  Was  ended  by  the 
(unfortunate)  marriage  of  her  friend. 

In  1885,  after  much  emotional  strain,  the  patient  became  ill  with 
symptoms  of  hystero-neurasthenia  (dyspepsia,  spinal  irritation,  and  tonic 
spasmodic  attacks;  attacks  of  hemiopia  with  migraine  and  transitory 
aphasia;  pruritus  pudendi  et  ani).  In  February,  1886,  these  symptoms 
disappeared. 

In  March  she  became  acquainted  with  her  present  husband,  and 
married  him  without  taking  much  time  for  reflection ;  for  he  was  rich, 
much  in  love  with  her,  and  his  character  was  in  sympathy  with  her  own. 

On  April  6th,  she  read  the  sentence,  "  Death  misses  no  one."  Like 
a  flash  of  lightning  in  a  clear  sky,  the  former  imperative  conceptions  of 
death  returned.  She  was  forced  to  meditate  on  the  most  horrible  manner 
of  death  for  herself  and  those  about  her,  and  constantly  imagine  death- 
scenes.  She  lost  rest  and  sleep,  and  took  no  pleasure  in  anything.  Her 
condition  improved.  Late  in  May,  1886,  she  was  married,  but  was  still 
troubled  by  painful  thoughts  at  that  time  :  that  she  would  bring  mis- 
fortune on  her  husbancf  and  those  about  her. 

First  coitus  on  June  6, 1886.  She  was  deeply  depressed  morally  by 
it.  She  had  had  no  such  conception  of  matrimony.  The  husband,  who 
really  loved  his  wife,  did  all  he  could  to  quiet  her.  He  consulted  phy- 
sicians, who  thought  all  would  be  well  after  pregnancy.  The  husband 
was  unable  to  explain  the  peculiar  behavior  of  his  wife.  She  was  friendly 
toward  him,  and  suffered  his  caresses.  In  coitus,  which  was  actually 
carried  out,  she  was  entirety  passive,  and  after  the  act  she  was  tired, 
exhausted  all  day  long,  nervous,  and  troubled  with  spinal  irritation. 

A  bridal  tour  brought  about  a  meeting  with  her  old  friend,  who  had 
lived  in  an  unhappjr  marriage  for  three  years.     The  two  ladies  trembled 


URNINGS.  277 

with  joy  and  excitement  as  they  sank  into  each  other's  arms,  and  became 
inseparable.  The  husband  saw  that  this  friendly  relation  was  a  pecnliar 
one,  and  hastened  their  departure.  He  had  an  opportunity  to  ascertain, 
through  the  correspondence  of  his  wife  with  this  friend,  that  the  letters 
interchanged  were  like  those  of  two  lovers. 

Mrs.  R.  became  pregnant.  During  pregnancy  the  remains  of  depres- 
sion and  imperative  ideas  disappeared.  In  September,  during  about  the 
ninth  week  of  pregnancy,  abortion  took  place.  After  that,  renewed  symp- 
toms of  hystero-neurasthenia.  In  addition  to  this,  there  were  anteflexio 
etlatero-positio  dextra  uteri,  anaemia,  and  atonia  ventriculi. 

At  the  consultation  the  patient  gave  the  impression  of  a  very 
neuropathic,  tainted  person.  The  neuropathic  expression  of  the  eyes 
cannot  be  described.  Appearance  entirely  feminine.  With  the  exception 
of  a  very  narrow,  arched  palate,  there  was  no  skeletal  abnormality.  With 
difficulty  the  patient  could  be  brought  to  give  the  details  of  her  sexual 
abnormality.  She  complained  that  she  had  married  without  knowing 
what  marriage  between  men  and  women  was.  She  loved  her  husband 
dearl}'  for  his  mental  qualities,  but  marital  intercourse  was  a  pain  to  her; 
she  did  it  unwillingly,  without  ever  finding  any  satisfaction  in  it.  Post 
actum,  all  day  long  she  was  weary  and  exhausted.  Since  the  abortion 
and  the  interdiction  of  sexual  intercourse  b}^  the  physicians,  she  had 
been  better;  but  she  thought  of  the  future  with  horror.  She  esteemed 
her  husband,  and  loved  him  mentally;  but  she  would  do  anything  for 
him,  if  he  would  but  avoid  her  sexually  in  the  future.  She  hoped  to 
have  sensual  feeling  for  him  in  time.  When  he  played  the  violin,  she 
seemed  to  feel  the  beginning  of  an  inclination  for  him  that  was  some- 
thing more  than  friendship;  but  it  was  only  transitory,  and  she  could 
get  no  assurance  for  the  future  in  it.  Her  greatest  happiness  was  in  cor- 
respondence with  her  former  lover.  She  felt  that  this  was  wrong,  but 
she  could  not  give  it  up;   for  to  do  so  made  her  miserable. 

It  is  remarkable  that  the  anomaly  may  be  long  limited  to 
mere  perversion  of  the  sexual  instinct,  and  that  the  impulse  to 
perverse  indulgence  may  make  its  appearance  after  some  acci- 
dental cause, — e.g.,  seduction,  or  some  neurosis.  Such  cases 
might  easily  be  mistaken  for  acquired  contrary  sexual  instinct 
(v.  supra),  if,  with  reference  to  the  sexual  feeling,  they  should 
not  be  demonstrated  by  the  history  to  be  original  and  con- 
genital. 

Case  118.  Mrs.  C,  aged  32,  wife  of  an  official,  a  large,  not  uncomely 
woman,  feminine  in  appearance,  comes  of  a  neuropathic  and  emotional 
mother.  A  brother  was  psychopathic,  and  died  of  drink.  Patient  was 
always  peculiar,  obstinate,  silent,  quick-tempered,  and  eccentric.     The 


278  PSYCHOPATHIA   SEXUALIS. 

brothers  and  sisters  are  excitable  people.  Pulmonary  plithisis  has  been 
frequent  in  her  family.  When  only  a  girl  of  thirteen,  with  signs  of  great 
sexual  excitement,  she  attracted  attention  by  enthusiastic  love  for  a 
female  friend  of  her  own  age.  Her  education  was  strict,  though  the 
patient  secretly  read  many  novels,  and  wrote  innumerable  poems.  She 
married  at  eighteen  to  free  herself  from  unpleasant  circumstances  at 
home. 

She  says  she  has  always  been  indifferent  toward  men.  In  fact,  she 
avoided  balls.  Female  statues  pleased  her.  Her  greatest  happiness  was 
to  think  of  marriage  with  a  beloved  woman-  She  was  not  aware  of  her 
sexual  peculiarity  until  marriage,  and  the  thing  had  remained  inexplica- 
ble to  her.  Patient  did  her  marital  duty,  and  bore  three  children,  two  of 
whom  were  subject  to  convulsions.  She  lived  pleasantly  with  her  hus- 
band, but  she  esteemed  him  only  for  his  moral  qualities.  She  gladly 
avoided  coitus.     "  I  should  have  preferred  intercourse  with  a  woman." 

Until  18T8  she  had  been  neurasthenic.  On  the  occasion  of  a  sojourn 
at  a  watering-place,  she  made  the  acquaintance  of  a  female  urning,  whose 
history  I  have  reported  as  Case  6,  in  the  Irrenfreund,  No.  1,  1884. 

The  patient  came  home  a  changed  person.  Her  husband  saj-s  :  "  She 
was  no  longer  a  woman,  no  longer  had  any  love  for  me  and  the  children, 
and  would  have  no  more  of  marital  approaches.  She  was  inflamed  with 
passionate  love  for  her  female  friend,  and  had  taste  for  nothing  else." 
After  the  husband  forbade  her  lover  the  house,  there  was  interchange  of 
letters  with  such -expressions  in  them  as  "  My  dove  I  I  live  only  for  you,  my 
soul."  There  were  meetings  and  frightful  excitement  when  an  expected 
letter  did  not  come.  The  relation  was  in  nowise  platonic.  From  certain 
indications  it  is  presumable  that  mutual  masturbation  was  the  means  of 
sensual  satisfaction.  This  relation  lasted  until  1882,  and  made  the  patient 
decidedly  neurasthenic. 

She  absolutely  neglected  the  house,  and  her  husband  hired  a  woman 
of  sixty  years  as  a  house-keeper,  and  also  a  governess  for  the  children. 
The  patient  fell  in  love  with  both,  who,  at  least,  allowed  caresses,  and 
profited  materially  through  the  love  of  their  mistress. 

In  the  latter  part  of  1883,  on  account  of  developing  pulmonary 
tuberculosis,  she  had  to  go  south.  There  she  became  acquainted  with  a 
Russian  lady  of  forty  3*ears,  and  fell  passionately  in  love  with  her ;  but 
she  did  not  meet  with  a  return  of  love  in  her  sense.  One  day  insanity 
became  manifest.  She  thought  the  Russian  lady  a  nihilist ;  that  she  was 
magnetized  by  her;  and  she  presented  formal  persecutory  delusions.  She 
fled,  and  was  caught  in  an  Italian  city,  and  placed  in  a  hospital,  where  she 
soon  became  quiet.  Again  she  followed  the  lady  with  her  love,  felt  herself 
very  unhappy,  and  planned  suicide. 

When  she  returned  home,  she  was  greatly  depressed  because  she  did 
not  have  the  lad}r,  and  was  contrary  toward  her  family.  A  delusive,  erotic 
state  of  excitement  came  on  about  the  end  of  May,  1884.     She  danced, 


EFFEMINATION  AND  VIRAGINITY.  279 

shouted,  and  called  herself  a  man ;  demanded  her  former  lovers,  and  said 
she  was  of  royal  blood.  She  escaped  from  the  house  in  male  attire,  and  was 
taken  to  the  asylum  in  a  state  of  eroto-maniacal  excitement.  After  a  few 
days  the  exaltation  disappeared.  The  patient  became  quiet,  and  made  a 
despairing  attempt  at  suicide ;  and  after  it  she  was  in  great  anguish  of 
mind  with  taedium  vitoe.  The  perverse  sexual  feeling  grew  less  and  less 
noticeable,  and  the  tuberculosis  progressed.  The  patient  died  of  phthisis 
in  the  beginning  of  1885. 

The  examination  of  the  brain  presented  nothing  unusual  as  far  as 
architecture  and  arrangement  of  convolutions  were  concerned.  Weight 
of  brain  1150  grammes.  Skull  slightly  asymmetrical.  No  anatomical 
signs  of  degeneration.     External  and  internal  genitals  without  anomaly. 

3.  Effemination  and  Viraginity. — There  are  various  tran- 
sitions from  the  foregoing  cases  to  those  making  up  this  category, 
characterized  by  the  degree  in  which  the  psychical  personality, 
especially  in  general  manner  of  feeling  and  inclinations,  is  in- 
fluenced by  the  abnormal  sexual  feeling.  In  this  group,  fully- 
developed  cases  in  men  are  females  in  feeling ;  in  women,  males. 
This  abnormality  of  feeling  and  of  development  of  the  character 
is  often  apparent  in  childhood.  The  boy  likes  to  spend  his  time 
with  girls,  play  with  dolls,  and  help  his  mother  about  the  house ; 
he  likes  to  cook,  sew,  knit,  and  develops  taste  in  female  toilettes, 
so  that  he  may  even  become  the  adviser  of  his  sisters.  As  he 
grows  older  he  eschews  smoking,  drinking,  and  manly  sports, 
and,  on  the  contrary,  finds  pleasure  in  adornment  of  person,  art, 
belles-lettres,  etc.,  even  to  the  extent  of  giving  himself  entirely 
to  the  cultivation  of  the  beautiful.  Since  women  possess  cor- 
responding inclinations,  he  prefers  to  move  in  the  society  of 
women. 

If  he  can  assume  the  role  of  a  female  at  a  masquerade,  it 
is  his  greatest  delight.  He  seeks  to  please  his  lover,  so  to 
speak,  by  studiously  trying  to  represent  what  pleases  the  female- 
loving  man  in  the  opposite  sex, — sweetness,  sympathy,  taste  for 
aesthetics,  poetry,  etc.  Efforts  to  approach  the  female  appear- 
ance in  gait,  attitude,  and  style  of  dress  are  frequently  seen. 

The  female  urning,  even  when  a  little  girl,  presents  the 
reverse.  Her  favorite  place  is  the  play-ground  of  boys.  She 
seeks  to  rival  them  in  their  games.  The  girl  will  have  nothing 
to  do  with  dolls ;  her  passion  is  for  playing  horse,  soldier,  and 


280  PSYCHOPATHIA   SEXUALIS. 

robber.  For  female  employments  there  is  manifested  not  merely 
a  lack  of  taste,  but  often  unskillfulness  in  them.  The  toilette 
is  neglected,  and  pleasure  found  in  a  coarse,  boyish  life.  Instead 
of  an  inclination  for  the  arts,  there  is  manifested  an  inclination 
and  taste  for  the  sciences.  Occasionally  there  may  be  attempts 
to  smoke  and  drink.  Perfumes  and  cosmetics  are  abhorred. 
The  consciousness  of  being  born  a  woman,  and,  therefore,  of 
being  compelled  to  renounce  the  University,  with  its  gay  life, 
and  the  army,  induces  painful  reflections. 

In  the  inclinations  of  the  amazon  for  manly  sports,  the  mas- 
culine soul  in  the  female  bosom  manifests  itself;  and  not  less  in 
the  show  of  courage  and  manly  feeling.  The  female  urning 
loves  to  wear  her  hair  and  have  her  clothing  in  the  fashion  of 
men ;  and  it  is  her  greatest  pleasure,  when  opportunity  offers, 
to  appear  in  male  attire.  Her  ideals  are  historical  and  contem- 
porary feminine  personalities  distinguished  for  mind  and  energy. 

With  reference  to  the  sexual  feeling  and  instinct  of  these 
urnings,  so  thoroughly  permeated  in  all  their  mental  being,  the 
men,  without  exception,  feel  themselves  to  be  females;  the 
women  feel  themselves  to  be  males.  Thus  they  feel  themselves 
to  be  antagonistic  to  persons  of  their  own  sex  constituted  like 
themselves ;  for,  of  course,  they  are  like  them  in  form.  But, 
on  the  other  hand,  they  are  drawn  toward  those  of  their  own 
sex  that  are  homo-sexual  or  sexually  normal.  The  same  jeal- 
ousy which  occurs  in  normal  sexual  life  also  occurs  here,  when 
rivalry  is  threatened ;  and,  indeed,  since  they  are,  as  a  rule, 
hyperaesthetic  sexually,  this  jealousy  is  often  boundless. 

In  cases  of  completely-developed  contrary  sexuality,  hetero- 
sexual love  is  looked  upon  as  a  thing  absolutely  incomprehensi- 
ble; sexual  intercourse  with  a  person  of  the  opposite  sex  is 
unthinkable,  impossible.  Such  an  attempt  brings  on  the  inhib- 
itory concept  of  disgust  or  even  horror,  which  makes  erec- 
tion impossible.  Only  two  of  my  transitional  cases  to  the  third 
category  were  able,  with  the  help  of  their  imagination,  by  think- 
ing of  themselves  as  men  with  reference  to  the  woman,  to  have 
cohabitation ;  but  the  act,  which  was  inadequate  for  them,  was 
a  great  sacrifice,  and  afforded  them  no  pleasure. 


EFFEMINATION   AND   VIRAGINITY.  281 

In  homo-sexual  intercourse  the  man  always  feels  himself,  in 
the  act,  as  a  woman ;  the  woman,  as  a  man.  The  means  of  in- 
dulgence, in  the  case  of  a  man,  where  there  is  irritable  weakness 
of  the  ejaculation  centre,  are  simply  succubus,  or  passive  coitus 
inter  femora  ;  in  other  cases,  passive  masturbation,  or  ejaculatio 
viri  dilecti  in  ore  proprio.  Many  have  a  desire  for  passive 
pederasty ;  occasionally  a  desire  for  active  pederasty  occurs.  In 
one  attempt  of  this  kind,  the  man  desisted  because  of  the  disgust 
which  seized  him  when  the  act  reminded  him  of  coitus. 

There  ivas  never  inclination  for  immature  persons  (boy- 
Jove).  Not  infrequently  there  were  only  platonic  desires.  The 
sexual  satisfaction  of  the  female  probably  consists  of  amor 
lesbicus,  or  active  masturbation. 

Case  119.  Autobiography.  "  1.  Descent:  I  am  now  in  my  twenty 
third  year.  I  have  chosen  the  study  of  the  technical  arts  as  an  occupa- 
tion, and  am  completely  satisfied  with  it.  I  had  but  the  mild  diseases 
of  children,  while  the  other  children,  who  are  now  healthy,  had  to  pass 
through  severe  illnesses.  My  parents  are  both  living,  and  my  father  is  an 
advocate.  He,  like  my  mother,  is,  as  we  say,  nervously  hyper-sensitive. 
In  my  father's  family  there  were  two  other  children,  who  died  early. 

"  2.  My  person :  As  for  my  physical  peculiarities,  I  am  of  robust 
figure,  without  being  of  especially  handsome  form  ;  eyes,  gray ;  hair, 
blonde ;  hair  and  beard  correspond  with  my  sex  and  years.  The  mammre 
and  genitals  are  normally  developed.  My  gait  is  firm  and  almost  heavy ; 
my  bearing,  careless.  It  is  remarkable  that  the  breadth  of  the  pelvis  is 
exactly  equal  to  that  of  the  shoulders. 

"  I  am  naturally  well  endowed  mentally.  In  one  of  my  certificates 
my  talents  are,  in  fact,  called  '  excellent.'  Without  any  particular  desire 
to  excel  in  them,  I  passed  my  examinations  with  distinction.  I  have  an 
interest  in  everything  that  concerns  the  well-being  of  humanity,  and  in 
science,  art,  and  industry.  With  my  energy  it  is  comparatively  easy  to 
postpone  for  a  time  the  satisfaction  of  my  desires,  which  will  be  described 
hereafter.  Intentionally  and  consciously,  I  curse  the  morality  of  to-day, 
which  forces  those  who  are  abnormal  sexually  to  break  laws  that  are 
voluntarily  established,  and  regards  sexual  congress  of  two  persons  of  the 
same  sex  as  a  matter  depending  on  the  choice  of  the  individual,  and 
a  matter  in  which  law-makers  have  a  right  to  interfere.  From  my 
studies  I  have  found  the  most  earnest  incentives  to  construct,  on  the 
basis  of  the  Darwinian  theory,  after  Carneri's  method,  a  system  of  morals, 
which,  to  be  sure,  does  not  harmonize  with  the  prevailing  system,  but 
which  seeks  to  elevate  and  improve  mankind  in  accordance  with  nat- 
ural law. 


282  PSYCHOPATHIA   SEXUALIg. 

"  I  think  that  there  are  not  many  marks  of  hereditary  taint  in  me. 
There  is  a  certain  hyper-sensitiveness.  A  very  intense  dream-life  is  per- 
haps important.  In  general,  it  is  occupied  with  indifferent  matters,  and 
never  has  so-called  sensual  images  as  a  subject ;  at  most,  in  this  direction, 
it  is  concerned  only  with  female  attire  and  putting  it  on,  which  for  me  is 
a  lustful  thought.  At  the  same  time,  until  my  sixteenth  year,  it  often 
went  to  the  extent  of  somnambulism  ..or,  very  frequently,  as  is  still  often 
the  case,  to  loud  talking  in  sleep.     (/^, 

"3.  My  inclinations:  The  above-mentioned  abnormal  proclivity  is 
the  fundamental  factor  in  my  sexual  feeling.  When  I  am  dressed  like  a 
woman,  I  feel  perfectly  satisfied.  A  peculiar  feeling  of  peace  and  comfort 
comes  over  me,  which  allows  me  to  work  mentally  with  greater  ease. 
My  libido  for  indulgence  in  sexual  intercourse  is  extremely  slight.  Too, 
I  have  much  love  and  taste  for  female  handiwork,  and,  without  assist- 
ance, I  learned  to  crochet  and  embroider,  and  I  like  to  do  these  things  in 
secret.  I  also  like  other  female  employments,  like  sewing,  etc. ;  so  that 
at  home,  where  I  keep  my  proclivity  perfectly  concealed,  and  guard 
against  indulging  it  by  involuntary  activity,  I  have  often  won  the  praise 
of  being  as  good  as  a  servant-girl ;  which  did  not  make  me  ashamed,  but, 
on  the  contrary,  filled  me  with  secret  pride.  I  can  make  nothing  out  of 
dancing  with  women ;  I  liked  to  dance  only  with  my  school-fellows,  for 
which  the  manner  of  our  instruction  in  dancing  gave  opportunity.  But 
in  this  it  gave  me  pleasure  only  when  I  could  dance  as  a  lady.  A  multi- 
tude of  other  desires  and  dreams,  which  seem  to  have  something  typical 
about  them,  I  pass  over,  because  they  seem  exactly  similar  to  those 
described  in  '  Psychopathia  Sexualis.'  ....  In  other  respects  my 
inclinations  are  not  different  from  those  of  my  sex.  I  smoke  and  drink 
moderately,  love  delicacies,  and  have  no  pleasure  in  physical  exercises. 

X^4.  Development :  After  this  brief  description  of  my  personality, 
I  may  pass  on  to  an  analysis  of  the  developmental  histor}'  of  my  abnor- 
mality. As  soon  as  I  was  able,  to  some  extent,  to  think  independently, 
and  I  understood  the  difference  between  the  sexes,  it  was  my  secret  and 
fixed  desire  to  be  a  girl.  In  fact,  I  believed  I  was  one.  But  when  in 
the  bath  I  saw  the  same  genitals  on  other  boys,  the  impossibility  of  my 
thought  became  apparent.  I  reduced  my  wish,  and  hoped  that  I  was  at 
least  an  hermaphrodite.  And,  owing  to  the  fact  that  I  had  a  certain 
shyness  about  looking  closely  at  pictures  or  descriptions  of  the  genitals, 
this  hope  was  entertained,  notwithstanding  the  fact  that  I  had  abundant 
opportunity  to  read  writings  on  the  subject,  until  my  studies  compelled 
me  to  make  a  closer  acquaintance  with  the  matter.  During  this  time  I 
read  everything  I  could  get  about  hermaphroditism,  and  longed  to  be  in 
the  place  of  the  female  who,  as  the  newspapers  often  reported,  had  been 
raised  as  a  male  and  been  restored  to  her  sex  by  accident.  The  recog- 
nition of  my  masculinity  made  an  end  of  this  dreaming,  and  did  not  fill 
me  with  any  especial  delight.     I  tried  to  destroy  my  sexual  glands  by 


EFFEMINATION   AKD   VIRAGINITY.  283 

gradual  pressure,  but  pain  soon  caused  me  to  desist.  My  longing  is 
still  for  the  external  characteristics  of  the  female  sex, — for  a  pretty 
coiffure,  a  rounded  breast,  a  slim  waist. 

"At  the  age  of  twelve  I  first  had  an  opportunity  to  put  on  female 
attire ;  and  I  soon  came  to  drape  myself,  by  means  of  bed-clothes,  bed- 
linen,  etc.,  with  female  petticoats.  When  I  grew  older,  it  was  my  great- 
est delight  to  put  on  my  sister's  dresses  secretly,  even  if  it  could  be  but 
for  a  few  moments,  and  with  constant  danger  of  detection.  Later,  much 
to  my  delight,  I  had  an  opportunity  to  play  a  female  role  in  a  love-scene ; 
and  it  is  said  that  I  was  not  at  all  bad  in  the  part.  When  I  began  to 
lead  an  independent  life  as  a  student,  I  immediately  obtained  female 
dresses  and  linen,  which  I  kept  in  order  myself.  When  at  night,  safe 
from  discovery,  I  can  put  on  one  article  after  another,  from  corset  to 
apron  and  bracelet,  I  am  perfectly  satisfied,  and  devote  myself  to  some 
quiet  employment,  inwardly  happy  and  full  of  delight  in  doing  it. 
While  dressing,  an  erection  usually  occurs,  but  it  is  never  followed  by 
an  ejaculation,  and  soon  disappears.  I  also  try  to  approximate  the 
female  appearance  in  externals,  by  arranging  my  hair  appropriately  and 
removing  the  beard,  which  I  should  have  preferred  to  tear  out. 

"5.  Sexual  inclinations:  In  passing  to  the  description  of  my 
sexual  proclivities,  I  desire,  first,  to  note,  in  general,  that  puberty 
occurred  normally,  as  I  judge  from  the  pollutions  that  occurred,  the 
change  of  voice,  etc.  Pollutions  still  occur  regularly  once  eve^  three 
weeks,  seldom  more  frequently.  With  them  I  never  experience  any  lust- 
ful feeling.  I  have  never  practiced  onanism ;  until  lately  I  knew 
nothing  more  of  it  than  its  name,  and  I  had  to  seek  direct  information 
about  it,  in  order  to  understand  it.  Any  touch  on  the  erect  penis  is 
disturbing  and  painful  to  me,  and  without  lustful  feeling. 

"Previously  I  behaved  veiy  shyly  toward  women,  but  I  now  act 
quietty,  and  associate  with  them  as  with  my  kind.  Direct  excitation,  in 
a  sexual  sense,  by  a  woman,  sometimes  occurred ;  but  when  I  try  to  analyze 
this,  it  seems  to  me  that  it  was  never  her  person,  but  rather  her  attire 
alone,  that  was  effectual.  I  fell  in  love  with  her  dress,  and  the  thought 
of  wearing  one  like  it  was  heavenly.  Thus  sexual  excitation  never  took 
place,  not  even  in  brothels  where  I  was  led  by  friends,  in  spite  of  the 
sight  of  the  greatest  voluptuousness  and  beauty.  But  friendly  feelings 
for  the  female  sex  were  in  my  heart.  I  imagined  how,  dressed  as  a  woman 
and  unrecognized,  I  could  stay  with  them,  associate  with  them,  and  take 
pleasure  with  them.  I  prefer  the  impression  made  on  me  by  girls  whose 
breasts  have  not  yet  fully  developed,  particularly  those  wearing  the  hair 
short ;  for  such  girls  are  more  nearly  like  me  and  my  aspect.  Once  I  was 
so  fortunate  as  to  find  a  girl  who  felt  unhappy  in  her  sex.  We  formed  a 
firm  bond  of  friendship  with  one  another,  and  we  often  took  delight  in 
the  idea  of  exchanging  places.  Perhaps  it  is  not  inappropriate  or 
unimportant  for  the  characterization,  to  record  the  following :     Some 


284  fSYCHOPATHlA    SEXUALIS. 

months  ago,  when  the  story  was  running  through  the  newspapers  of 
an  Hungarian  countess  who,  dressed  as  a  man,  had  married,  and  felt 
like  a  man,  in  all  earnestness,  I  thought  of  offering  myself  to  her,  in 
order  to  contract  an  inverted  marriage, — she  as  hushand,  I  as  wife. 
.  .  .  I  have  never  attempted  coitus,  and  have  never  felt  any  desire 
for  it.  But  since  I  foresaw  that  the  erection  necessary  with  a  woman 
would  he  wanting,  I  thought  of  putting  on  some  of  her  clothing ;  and  I 
think  that  then  the  expected  result  would  occur. 

"  As  for  my  behavior  toward  male  persons,  first  of  all,  it  is  to  be 
emphasized  that  I  had  the  warmest  friendships  during  my  school-days. 
My  heart  was  full  of  happiness,  if  I  could  do  some  small  service  for  the 
object  of  my  devotion.  I  really  worshiped  him  passionately.  But,  on 
the  slightest  occasion,  I  evinced  terrible  jealousy;  and  while  my  anger 
lasted  I  felt  as  if  I  could  neither  live  nor  die.  When  reconciliation  oc- 
curred, for  a  short  time  I  was  the  happiest  of  creatures.  I  also  tried  to 
make  friends  of  boys,  whom  I  bribed  with  sweetmeats,  and  whom  I  should 
gladly  have  kissed.  Though  my  love  always  remained  platonic,  yet  it  is 
abnormal.  An  expression  that  I  unconsciously  made  at  that  time  about 
an  elder  friend,  whom  I  worshiped,  shows  that.  I  said  I  loved  him  so 
that  I  should  have  liked  to  marry  him.  And  even  now,  when  I  indulge 
but  little  in  intercourse,  I  am  easily  taken  with  a  handsome  man  with 
a  fine  beard  and  refined  features.  Yet  I  have  never  met  a  being  feeling 
like  myself,  whom  I  could  confide  in,  and  with  whom  I  could  live  as  a 
female  friend.  I  never  attempted  to  exercise  my  inclinations  directly, 
and  never  committed  any  foolish  act  of  this  kind.  Finally  I  ceased  to 
visit  museums  where  nude  male  figures  were  displayed;  for  the  ei*ec- 
tions,  which  were  sure  to  occur,  were  exceedingly  annoying.  I  had 
often  secretly  wished  to  sleep  with  a  man,  and  often  found  oppor- 
tunity. I  was  asked  by  a  rather  unattractive  elderly  man  to  sleep  with 
him.  Cum  eo  concubui,  ille  genitalia  mea  tetigit ;  and  though  his 
person  was  unattractive  to  me,  I  was  filled  with  an  intense  feeling  of 
lust.  I  felt  as  if  completely  surrendered  to  him ;  in  a  word,  I  felt  like  a 
woman. 

"  If  I  may  be  permitted  to  add  a  concluding  word  to  what  I  have 
already  said,  I  wish  to  state  expressely  that,  though  I  am  conscious  of 
the  abnormality  of  my  inclinations,  I  have  no  desire  to  change  them ;  I 
long  only  for  a  time  when,  more  easily  and  with  less  danger  of  discovery, 
I  can  give  rein  to  my  desires  and  experience  a  delight  that  will  harm 
no  one." 

Case  120.  Miss  Z.,  aged  31,  artist,  comes  for  consultation  on  ac- 
count of  neurasthenic  symptoms.  She  is  remarkable  for  coarse,  mascu- 
line features,  a  deep  voice,  short  hair,  a  masculine  style  of  dress,  mascu- 
line gait,  and  self-consciousness.  In  other  respects  she  is  feminine,  with 
well-developed  mammae  and  a  female  pelvis,  and  without  any  indication 
of  beard. 


EFFEMINATION   AND   VIRAGINITY.  285 

Examination  with  reference  to  contrary  sexual  instinct  gives  a 
positive  result : — 

The  patient  states  that  even  when  a  little  girl  she  preferred  to  play 
with  boys,  and  particularly  "  soldier,"  "  merchant,"  and  "  robber."  She 
was  very  wild  and  unrestrained  in  these  games  with  boys,  but  never  had 
any  proclivity  for  dolls  or  female  employment,  of  which  she  learned  only 
the  most  ordinary  things  (knitting,  sewing).  /^- 

In.  school  she  made  good  progress,  being  especially  interested  in 
mathematics  and  chemistry.  She  early  had  a  desire  for  sculpture,  and 
showed  talent  for  it.  Her  greatest  ambition  was  to  become  a  real  artist.  In 
her  dreams  of  the  future,  she  never  thought  of  marriage.  As  an  artist,  she 
was  interested  in  handsome  men,  but  she  was  really  attracted  only  by 
female  forms;  she  saw  male  forms  only  "  in  the  distance."  She  could 
never  endure  "  trumpery  " ;  "  manly  dress  "  was  all  that  pleased  her. 
The  ordinary  society  of  girls  was  repugnant  to  her,  because  their  talk 
about  toilettes,  ornaments,  and  love-affairs  with  men,  seemed  stale  and 
tiresome  to  her.  On  the  other  hand,  since  her  childhood  she  had  had 
enthusiastic  friendships  witli  certain  girls  ;  at  the  age  of  ten  she  was  in 
love  with  a  girl  companion,  and  wrote  her  name  everywhere.  Since  then 
she  had  had  numerous  female  friends,  with  whom  she  had  indulged  in 
passionate  kissing.  She  pleased  the  girls,  as  a  rule,  because  of  her  mas- 
culine bearing.  She  wrote  poems  to  her  female  friends,  and  could  have 
done  anything  out  of  love  for  them.  To  her  it  was  very  remarkable  that 
she  was  embarrassed  before  girls,  especially  when  they  were  friends. 
She  could  not  undress  before  them.  The  more  she  loved  a  friend,  the 
more  modest  she  was  before  her. 

At  the  present  time  she  has  such  a  relation.  She  kisses  and  em- 
braces her  Laura,  walks  by  her  window,  and  suffers  all  the  pangs  of 
jealousy,  particularly  when  she  sees  her  conversing  with  men.  Her  only 
wish  is  to  live  always  with  this  female  friend. 

The  patient  states,  however,  that  twice  in  her  life  men  have  made 
an  impression  on  her.  She  thinks  that  if  she  had  been  really  sought, 
there  would  have  been  a  marriage  ;  for  she  is  very  fond  of  family  life  and 
children.  If  a  man  wished  to  possess  her,  it  would  be  necessary  for  him 
to  win  her  ;  she  herself  would  prefer  to  win  a  female  friend.  She  thinks 
woman  is  more  beautiful  and  ideal  than  man.  In  her  infrequent  erotic 
dreams,  the  subject  had  always  been  a  female.  She  had  never  dreamed 
of  men.  She  does  not  think  that  she  could  now  love  a  man ;  for  men 
are  false,  and  she  herself  is  nervous  and  ansemic. 

She  considers  herself  a  woman  in  all  respects,  but  regrets  that  she 
is  not  a  man.  Even  at  the  age  of  four  it  had  been  her  greatest  pleasure 
to  put  on  boys'  clothes.  She  certainly  had  a  masculine  character,  and, 
too,  had  never  wept.  Her  greatest  passion  was  for  riding,  gymnastics, 
fencing,  and  driving.  She  suffered  much  because  no  one  about  her 
understood  her.     It  seemed  silly  to  her  to  talk  about  feminine  things. 


286  PSYCHOPATHIA   SEXUALIS. 

Many  of  her  acquaintances  had  thought  that  she  should  really  have 
been  a  man. 

The  patient  says  that -she  was  never  sensual.  In  embracing 
female  friends,  she  had  often  experienced  a  peculiar  lustful  feeling. 
Embracing  and  kissing  had  been  her  only  manner  of  expressing  her 
friendship. 

The  patient  states  that  she  comes  of  a  nervous  father,  and  an  insane 
mother  who,  as  a  young  girl,  had  been  passionately  in  love  with  her  own 
brother,  and  bad  tried  to  induce  him  to  flee  with  her  to  America.  The 
patient's  brother  is  a  very  eccentric,  peculiar  man. 

The  patient  presents  no  external  degenerative  signs ;  head  regular. 
She  says  the  menses  began  at  fourteen,  and  that  they  have  been  regular, 
but  alwaj'S  painful. 

Case  121.  "  In  order  to  designate  at  once  my  unhappy  diseased 
condition  with  its  correct  name,  I  will  state  at  the  beginning  that  it  bears 
all  the  marks  of  what,  in  your  work, '  Psychopathia  Sexualis,'  you  have 
named  effemination. 

"  I  am  now  thirty-eight  3rears  old,  and,  thanks  to  my  abnormality, 
I  look  back  on  a  life  that  has  been  full  of  indescribable  suffering ;  so 
that  I  am  often  astonished  to  think  what  capacity  for  suffering  a  man  has. 
Of  late  consciousness  of  the  suffering  I  have  endured  has  become  the 
source  of  a  kind  of  self-respect,  which,  in  itself,  makes  my  life,  in  a  measure, 
endurable. 

u  But  I  shall  now  endeavor  to  describe  my  condition  with  all  truth. 
I  am  physically  healthy,  and,  as  far  as  I  can  remember,  have  never  had 
any  severe  illness.  I  come  of  a  healthy  family.  But  my  parents  are 
both  of  a  very  excitable  nature,  my  father  being  of  the  so-called  choleric, 
and  my  mother  of  the  sanguine,  temperament;  she  has  a  strong  tendency 
to  mild  melancholia.  She  is  a  lively  woman,  loved  for  her  good-hearted- 
ness  and  active  benevolence  ;  but  she  is  still  very  dependent  and  deficient 
in  self-confidence.  All  these  peculiarities  were  marked  in  her  father.  I 
mention  this  fact,  because  I  am  told  that  I  resemble  them  both ;  and  as 
far  as  the  last  two  peculiarities  are  concerned,  I  can  myself  acknowledge 
the  resemblance.  But  when  I  made  attempts,  by  means  of  my  inner 
strength  and  by  thinking  of  my  own  power,  to  rend  the  bond  that,  with 
magic  force,  draws  me  to  men,  there  was  always  a  residuum  left  that 
[  could  not  eradicate.  As  far  as  I  can  remember,  I  have  always  had  this 
elementary  longing  for  a  male  lover.  To  be  sure,  its  first  expressions 
were  of  a  coarse,  sensual  nature.  I  do  not  know  whether  I  was  yet  ten 
years  old,  when,  while  lying  in  bed  in  the  day-time,  I  suddenly  discovered 
how,  by  pressure  on  my  genitals,  I  induced  a  new  and  intoxicating  feeling, 
while  fancying  that  a  man  of  my  acquaintance  performed  sensual  manip- 
ulations on  me.  It  was  only  many  3-ears  afterward  that  I  learned  that 
this  was  onanism.  At  first  I  was  so  frightened  and  so  depressed  by  the 
inexplicableness  of  my  longing,  that  I  then  made  my  first  attempt  at 


EFFEMINATION    AND   VIRAGINITY.  287 

suicide.  If  I  had  only  put  it  into  execution  !  For  since  then  there  has 
been  such  frequent  violent  agitation  of  mind  and  body  that  my  heart  has 
been  bound  as  with  a  chain,  and  made  cold.  I  may  say  at  once  that,  up 
to  the  present  time,  onanism  has  not  loosened  me  from  its  clutches ;  it 
has  overcome  all  attempts  and  efforts  to  escape,  and  my  desire  to  resist 
it  is  almost  destro}red.  Three  or  four  times  I  have  given  it  up  for  a 
month  at  a  time,  usually  under  the  influence  of  mental  excitemenW^ 

"  When  about  thirteen,  I  had  my  first  love.  To-day  it  seems  asn 
my  greatest  wish  then  was  to  kiss  my  school-fellow's  fresh,  rosy  lips.  It 
was  a  passion  full  of  romantic  dreams.  At  the  age  of  fifteen  or  sixteen 
it  became  more  violent,  when  I  first  experienced  the  insane  pangs  of  a 
jealousy  which  is  more  terrible  than  that  of  natural  love  can  be.  This 
second  period  of  my  life  lasted  for  years,  though  I  spent  but  a  few  days 
with  the  object  of  my  passion ;  and  then  we  did  not  see  each  other  for 
fifteen  years.  Gradually  my  feeling  cooled,  and  I  then  fell  passionately  in 
love  several  times  with  other  men,  who,  with  the  exception  of  one,  were 
about  my  own  age. 

"  My  love — if  you  will  kindly  allow  this  expression  for  a  feeling  con- 
demned by  the  majority  of  mankind — has  never  been  returned ;  I  have 
never  had  intercourse  with  a  man  in  any  way  that  would  not  bear  the 
light  of  day  ;  never  has  any  one  shown  even  extraordinary  interest  in  me, 
though  one  of  my  friends  discovered  my  secret  longing  ;  and  yet  I  have 
had  a  burning  desire  for  masculine  love.  In  this  longing  my  feelings 
seem  to  me  to  be  entirely  those  of  a  loving  woman ;  and  I  notice,  with 
horror,  that  my  sensual  ideas  grow  more  and  more  like  those  of  a  woman. 
During  the  periods  when  I  am  free  from  any  particular  love,  my  long- 
ing degenerates  so  that,  in  my  onanistic  manipulations,  I  conjure  up  only 
coarse,  sensual  ideas.  But  I  am  still  finally  able  to  overcome  these.  My 
efforts  to  repress  the  love,  however,  are  absolutely  vain.  At  the  present 
time  I  am  again  suffering  with  such  an  exaggerated  state  of  feeling  that 
has  existed  for  months ;  and  I  have  pondered  so  much  over  its  peculiari- 
ties that  I  think  I  can  describe  my  feelings  truthfully.  In  this  way  I 
have  made  the  peculiar  observation  that  I  have  never  loved  a  bearded 
man.  From  this  it  might  easily  be  presumed  that  I  am  given  to  so-called 
boy -love ;  but  that  is  not  the  case.  For,  to  the  sensual  charm,  on  closer 
association,  a  mental  interest  is  added.  With  this  begins  the  mental 
pain.  I  am  seized  with  such  a  passionate  longing  that  I  am  willing  to 
sacrifice  myself,  in  a  way.  I  excite  confidence  in  myself;  and  from  this 
mutual  feeling  a  heart-felt  friendship  might  be  engendered,  if  deep  down 
in  my  soul  were  not  sleeping  the  demon  which  impels  me  to  the  closest 
of  relationships,  which  is  allowed  only  between  human  beings  of  op- 
posite sex.  My  whole  being,  every  fibre  of  my  body,  longs  for  it,  and 
I  am  consumed  by  a  hot,  glowing  passion.  I  wonder  that  here  I  can  again 
describe  in  unfeeling  words  the  feelings  that  coursed  through  my  whole 
being.     Of  course,  by  the  struggle  of  years,  I  have  been  forced  to  learn 


288  PSYCHOPATHIA   SEXUALIS. 

to  conceal  my  inclination,  and  smile  when  torn  by  pain.  For,  in  never 
having  my  love  returned,  I  have  learned  to  know  all  the  sufferings  of 
love.  Jealousy — insane,  blinding  jealousy — of  any  and  every  body  who 
casts  but  a  friendly  glance  at  the  object  of  my  secret  love! 

"  I  have  emphasized  the  mental  element,  in  order  to  show  how 
deeply  rooted  my  abnormal  impulse  is.  I  have  never  felt  the  slightest 
touch  of  sensual  love  for  the  opposite  sex.  The  idea  of  being  forced  to 
associate  sensually  with  women  is  repugnant  to  me.  At  times  I  have 
suffered  enough  on  being  assured  of  the  love  of  young  girls.  Like  every 
young  man,  I  have  had  abundant  opportunity  to  enjoy  the  modern  social 
pleasures,  dancing  among  them.  I  like  to  dance ;  but  if  I  could  dance 
with  men,  as  a  girl,  I  should  be  really  happy. 

"  I  wish  once  more  to  remark  that  my  love  is  entirely  sensual. 
How  could  I  otherwise  explain  the  fact  that  the  pressure  of  my  lover's 
hand,  often  merely  his  glance,  causes  palpitation  and  erection  1  I  have 
done  everything  to  eradicate  this  love  from  my — let  us  say  '  heart.'  I 
have  tried  to  still  it  by  means  of  onanism ;  to  drag  it  in  the  mire,  in 
order  to  raise  myself  above  it.  (About  ten  years  ago,  during  such  a 
time  of  love,  I  avoided  onanism,  and  felt  that  my  feeling  of  love  elevated 
me.)  I  still  entertain  the  delusion  that  if  the  object  of  my  love  were  to 
tell  me  he  loved  me,  that  he  loved  me,  and  only  me,  I  should  willingly 
give  up  sensual  gratification  to  repose  in  faithful  arms.  But  that  is 
certainly  a  self-deception. 

'*  Honored  sir,  I  have  a  responsible  occupation,  and  I  think  I  can 
give  the  assurance  that  my  abnormal  inclination  has  never,  even  in  a 
hair's  breadth,  caused  me  to  deviate  from  the  duty  imposed  on  me. 
Aside  from  this  abnormality,  I  am  not  insane,  and  I  might  ultimately 
become  contented ;  but  I  have,  particularly  of  late  years,  suffered  too 
much  not  to  look  on  the  future  with  painful  feeling.  For  the  future  will 
certainly  not  bring  fulfillment  of  the  desire  which  constantly  glows 
under  the  ashes, — the  desire  to  possess  a  lover  who  understands  and 
returns  my  love.  Such  a  relation  would  make  me  truly  happy.  I  have 
thought  much  about  the  origin  of  my  abnormality,  particularh/  because 
I  think  I  am  forced  to  assume  that  it  was  not  inherited.  I  believe  that 
onanism  has  changed  the  inborn  feeling  into  a  burning  passion.  I  might 
long  ago  have  put  an  end  to  my  misery,  since  I  have  no  fear  of  death, 
and  since  in  religion — which,  strange  to  say,  has  not  departed  from  my 
impure  heart — I  find  no  warning  against  suicide.  But  the  conscious- 
ness that  I  am  not  alone  responsible,  and  that  a  worm  lias  nipped  my 
whole  life  in  the  bud, — a  certain  comfort  that  has  sprung  up  of  late  out 
of  indescribable  suffering, — leads  me  to  see  whether  comparative  happi- 
ness in  life  cannot  be  obtained  on  an  entirely  new  basis :  something 
which  fills  the  whole  heart.  I  think  I  could  be  happy  under  the  influence 
of  quiet  family  life.  But  I  dare  not  conceal  from  you  the  fact  that  the 
thought  of  married  life  with  a  wife  is  terrible  to  me,  and  that  I  make  the 


EFFEMINATION    AND    VIRAGINITY.  289 

attempt  of  a  change  of  life  with  a  bleeding  heart ;  for  thus  I  absolutely 
abandon  the  hope  that  is  always  awake ;  namely,  the  delusion  that  fate 
may  jret  bring  me  the  desired  happiness. 

"  This  delusion  is  so  deeply  rooted  in  me  that  I  think  nothing  but 
hypnotic  suggestion  could  help  me.  If  you  could  advise  me,  you  would 
make  me  unspeakably  happy.  Of  course,  your  strictest  injunction  would 
be  to  abandon  onanism.  How  gladly  I  would  follow  it!  But  if  I  were 
not  to  have  direct  physical,  some  mechanical,  means  at  hand  to  help  me, 
I  should  certainly  be  unable  to  free  myself  from  this  vice  ;  and  this  the 
more,  because  I  fear  that,  by  long  years  of  habit,  my  nature  has  become 
accustomed  to  it.  Of  course,  I  have  not  escaped  the  effects  of  it,  even 
though  they  are  not  so  terrible  as  they  are  often  pictured.  I  suffer  with 
mild  nervousness,  am,  indeed,  weakened,  and  have  periodical  disturbance 
of  digestion ;  but  I  can  still  endure  hard  work,  and  take  a  certain 
pleasure  in  it,  when  it  is  not  too  great.  I  am  depressed,  but  I  can  be 
happy,  and,  fortunately,  I  take  pleasure  in  my  calling,  and  am  interested 
in  various  things,  particularly  music,  art,  and  belles-lettres.  I  have  never 
indulged  in  female  pursuits. 

uAs  may  be  seen  from  the  foregoing,  I  like  to  associate  with 
men,  especially  with  those  who  are  handsome ;  but  I  have  never 
had  intimate  relations  with  them.  A  wide  gulf  separates  me  from 
theml 

" Postscript :  I  feared  that  in  the  foregoing  I  had  not  described  my 
sexual  life  with  sufficient  exactness.  It  consists  only  in  onanism ;  but  in 
it  I  abandon  myself  to  almost  all  the  repugnant  acts  that  are  compre- 
hended under  coitus  inter  femora,  ejaculatio  in  ore,  etc. 

"  My  rdle  is  passive.  When  I  am  seized  by  a  passion,  the  ideas 
change,  and  become  entirely  a  desire  to  be  impregnated.  The  struggle 
against  such  a  passion  is  so  terrible,  because  my  mind  is  also  impli- 
cated. I  long  for  the  closest,  the  most  complete  union  that  can  be 
conceived  as  existing  between  two  men, — always  together,  common  in- 
terests, unlimited  confidence,  sexual  union.  I  think  that  natural  love 
is  different  from  this  only  in  its  degree  of  warmth ;  it  does  not  reach 
the  boiling-point  of  our  passion.  Just  now  I  am  fighting  the  battle 
over  again;  with  force  I  stifle  the  insane  passion  that  has  so  long 
enthralled  me.  All  night  long  I  walk  about,  followed  by  the  image  of 
him  I  love ;  for  love  of  whom  I  would  give  up  all  I  possess.  How  sad 
it  is  that  the  noblest  feeling  given  to  man — friendship — is  sullied  by 
common  sensual  feeling  1 

"  I  wish  once  more  to  state  that  I  cannot  come  to  the  determination 
to  transform  my  sexual  life  by  means  of  sexual  intercourse  with  the 
opposite  sex.  The  thought  of  such  intercourse  fills  me  with  repugnance 
and  disgust." 

Case  122.  "  I  write,  as  well  as  I  can,  the  history  of  my  suffering, 
actuated  only  by  the  desire,  by  this  autobiography,  to  clear  up  to  some 


290  PSYCHOPATHIA   SEXUALIS. 

extent  the  misunderstanding  and  errors  concerning  '  contrary  sexual 
instinct '  which  are  still  so  widely  prevalent. 

"  I  am  thirty-seven  years  old,  and  come  of  healthy  parents,  both  of 
whom  were  very  nervous.  I  only  mention  this,  because  I  have  often  had 
the  thought  that  my  contrary  sexual  instinct  came  by  way  of  inheritance ; 
but  this  is  nothing  more  than  vague.  Of  my  grandparents,  whom  I  did 
not  know,  the  only  remarkable  thing  I  can  mention  is,  that  my  maternal 
grandfather  was  known  as  a  great  Don  Juan. 

"I  was  rather  a  weak  child,  and  during  my  first  two  years  suffered 
severely  with  fits,  as  a  result  of  which  my  understanding  and  memory 
may  have  suffered ;  for  I  learn  but  slowly  things  which  do  not  particularly 
interest  me,  and  easily  forget  them.  I  may  also  mention  that,  during 
the  time  before  I  was  born,  my  mother  was  subject  to  violent  mental 
excitement,  and  was  often  frightened.  From  my  third  year  I  have  been 
perfectly  well,  and  have  escaped  severe  illness.  Only  when  a  boy,  from 
the  age  of  twelve  to  sixteen,  I  had  peculiar,  indescribable  nervous  sen- 
sations, which  made  themselves  felt  in  my  head  and  finger-tips,  and  in 
which  it  seemed  to  me  as  if  my  whole  being  were  about  to  cease.  For 
many  years,  however,  these  attacks  have  ceased  to  occur.  I  am  rather  a 
powerful  man,  with  abundant  growth  of  hair,  and  in  all  respects 
masculine. 

"  Even  when  a  boy  of  six  years,  I  came  independently  to  mastur- 
bate, and,  until  my  nineteenth  year,  I  practiced  the  vice  quite  persistently; 
and  even  now,  faute  de  mieux,  I  quite  frequently  resort  to  it,  notwith- 
standing the  fact  that  I  understand  the  vileness  of  the  passion,  and 
always  feel  somewhat  weakened  after  it.  But  sexual  intercourse  with  a 
man  does  not  affect  me  in  the  least ;  on  the  contrary,  it  gives  me  a  feel- 
ing of  being  strengthened.  I  began  school  at  the  age  of  seven,  and 
soon  experienced  an  intense  feeling  of  sympathy  for  my  companions, 
which,  however,  made  no  other  impression  on  me.  In  the  Gymnasium, 
at  the  age  of  fourteen,  my  companions  explained  to  me  the  sexual  life 
of  man,  which,  up  to  that  time,  was  absolutely  unknown  to  me ;  but  I 
was  not  much  interested  in  the  matter.  At  this  time  I  also  practiced 
mutual  onanism  with  two  or  three  friends  who  had  seduced  me  into  it ; 
and  it  had  an  extraordinary  charm  for  me.  I  was  still  perfectly  uncon- 
scious of  the  perversity  of  my  sexual  instinct,  and  considered  my  vices 
as  sins  of- youth,  like  those  committed  by  all  botys  of  the  same  age. 
Interest  in  the  female  sex  I  thought  would  come  in  time.  Thus  I 
became  nineteen  years  old.  During  the  following  years  I  fell  insanely 
in  love  three  times, — once  with  a  very  handsome  actor,  then  with  a  bank 
employe*,  and  with  one  of  my  friends,  the  last  two  being  men  who  were 
nothing  less  than  beautiful,  and  calculated  to  excite  sensual  feeling.  But 
this  love  was  merely  platonic,  and  occasionally  found  expression  in  glow- 
ing poetry.  It  was,  perhaps,  the  most  perfect  period  of  my  life ;  for  I 
regarded  everything  with  pure,  innocent  eyes.     In  my  twenty-first  year 


EFFEMINATION    AND   VIRAGINITY.  291 

I  gradually  began  to  notice  that  I  was  not  constituted  exactly  like  my 
comrades ;  for  I  found  no  pleasure  in  masculine  pursuits.  I  had  but 
little  liking  for  smoking,  drinking,  and  card-playing,  and  I  was  frightened 
to  death  by  a  brothel.  I  have  never  been  in  one ;  I  was  always  able  to 
avoid  visiting  one  on  some  pretext  or  other.  But  I  now  began  to  think 
about  myself;  1  often  felt  terribly  lonesome,  miserable,  and  unhappy, 
and  longed  for  a  friend  constituted  like  myself,  without,  however,  ever 
thinking  that  there  could  be  other  men  like  me.  At  twenty-two  I  made 
the  acquaintance  of  a  young  man  who  finally  explained  to  me  contrary 
sexual  instinct  and  the  individuals  affected  with  it.  He,  being  also  an 
urning,  was  in  love  with  me.  It  was  as  if  scales  had  fallen  from  my  eyes ; 
and  I  bless  the  day  this  explanation  came  to  me.  From  that  time  I  saw 
the  world  with  different  eyes ;  I  saw  that  many  others  were  given  the 
same  fate  ;  and  I  began  to  learn  to  content  myself  with  this  lot  as  well  as 
I  could.  Unfortunately,! did  not  succeed  very  well,  and  I  am  still  often 
seized  with  bitterness  and  a  deep  hatred  of  the  modern  ideas  which  treat 
us  poor  urnings  with  such  terrible  harshness.  For  what  is  our  fate?  In 
most  cases  we  are  not  understood,  and  are  derided  and  despised;  and 
even  when  all  goes  well,  and  we  are  understood,  we  are  still  pitied  like 
invalids  or  the  insane, — and  pity  was  always  sickening  to  me.  I  now 
began  to  play  a  part,  in  order  to  deceive  my  fellow-men  as  to  m}^  state 
of  mind  ;  and  it  always  gave  me  great  satisfaction  to  succeed  in  this.  I 
made  the  acquaintance  of  several  men  like  myself,  with  whom  I  estab- 
lished relations,  which,  however,  never  lasted  long ;  for  I  was  verjr 
fearful  and  cautious  ;  but,  at  the  same  time,  I  was  very  particular  and 
easily  wearied. 

"  I  have  always  absolutely  despised  pederasty  as  something  un- 
worthy a  man,  and  I  only  wish  that  all  those  like  me  would  do  the  same  ; 
but,  unfortunately,  with  many  this  is  not  the  case.  If  all  like  me  thought 
as  I  do,  then  the  contempt  and  scoffing  of  men  that  feel  differently  would 
be  a  still  greater  injustice  to  us  than  it  now  is. 

"  Toward  the  man  I  love  I  feel  completely  like  a  woman,  and,  there- 
fore, in  the  sexual  act  I  am  quite  passive.  In  general,  my  whole  sensibility 
and  feeling  are  feminine.  I  am  vain,  coquettish,  fond  of  ornament,  and 
like  to  please  others.  I  love  to  dress  myself  beautifully,  and,  in  cases 
where  I  wish  to  please,  I  even  make  use  of  the  arts  of  the  toilet,  in  which 
I  am  quite  skilled. 

"  While  I  have  but  little  interest  in  politics,  I  am  passionately  fond 
of  music  and  an  inspired  follower  of  Richard  Wagner.  I  have  noticed 
this  preference  in  the  majority  of  us ;  I  find  that  this  music  is  perfectly 
in  accord  with  our  nature. 

"  I  play  the  violin  quite  well ;  I  like  reading,  and  read  much,  but  I 
have  little  interest  in  anything  else.  Everything  else  in  life  is  quite  in- 
different to  me,  owing  to  the  deep  resignation  that  more  and  more  takes 
possession  of  me. 


292  PSYCHOPATHIA   SEXUALIS. 

"  Even  though  I  should  have  reason  to  be  satisfied  with  my  fate,  in 
that  I  have  an  assured  position  in  a  technical  employment  in  a  large  city 
of  Germany,  still  I  take  no  pleasure  in  my  calling.  I  should  be  best 
suited  if,  independent  and  free,  I  could  travel  about  with  a  handsome 
lover,  and  live  for  music  and  literature,  particularly  for  the  theatre,  which 
seems  to  me  to  be  one  of  the  greatest  pleasures.  A  connection  with  a 
court  theatre  I  think  of  as  being  very  acceptable. 

"  The  only  position  or  calling  that  seems  really  desirable  to  me  is 
that  of  a  great  artist, — singer,  actor,  painter,  or  sculptor ;  and  it  seems 
to  me  that  it  would  be  even  finer  to  be  born  to  the  throne  of  a  king, — a 
wish  that  is  in  harmony  with  my  pronounced  desire  for  power.  (If  there 
is  really  such  a  thing  as  transmigration  of  souls,  a  subject  I  have  studied 
much,  and  which  seems  to  me  to  clear  up  much,  I  must  have  lived  at  one 
time  as  an  emperor,  or  ruler  of  some  kind.)  But  a  man  must  be  born  to 
all  this ;  and  since  I  am  not,  I  am  without  ambition  for  so-called  social 
honors  and  distinctions. 

"  As  to  my  tastes,  I  must  mention  a  painful  dissension  there  is  in 
them.  Handsome,  intellectual  young  men  of  at  least  twenty  years,  who 
must  be  of  my  own  social  station,  seem  to  me  to  be  suited  rather  for 
platonic  love ;  but  with  them  I  satisfy  myself  completely  with  a  straight- 
forward, though  ideal,  friendship,  which  seldom  goes  beyond  a  few  kisses. 
But  I  can  be  excited  sensually  only  by  coarse,  powerful  men  that  are  at 
least  of  my  own  age,  and  mentally  and  socially  beneath  me.  The  reason 
for  this  strange  phenomenon  may  be  that  my  pronounced  feeling  of  shame 
and  my  innate  apprehensiveness,  with  my  cautious  disposition,  have  the 
effect  of  an  inhibitory  idea  with  men  of  my  own  social  position;  so 
that  with  them  it  is  with  difficulty  and  seldom  that  I  can  induce  sexual 
excitement  in  myself.  That  this  diversity  is  painful  to  me  is  owing  to 
the  fact  that  I  am  always  afraid  to  discover  myself  to  these  simple  men, 
below  me  in  station,  who  may  often  be  bought  with  money.  But  I  can- 
not imagine  anything  worse  than  a  scandal,  which  would  at  once  drive  me 
to  suicide.  For  I  can  think  of  nothing  more  terrible  than,  through  some 
slight  act  of  carelessness  or  the  enmity  of  any  man,  suddenly  to  be 
branded  before  the  world,  and  to  be  powerless  to  avert  it.  But  what  is  it 
that  we  do  that  is  so  different  from  what  normally  constituted  men  can 
do,  at  least,  quite  as  frequently  without  embarrassment,  and  without 
shame  ?  That  we  do  not  feel  as  the  crowd  feels  is  not  our  fault,  but  a 
cruel  trick  of  Nature. 

"  Innumerable  times  I  have  puzzled  my  brain  to  know  whether 
science,  or  any  of  her  free  and  unprejudiced  devotees,  could  think  of  any 
way  in  which  to  give  us  step-children  of  Nature  a  more  endurable  posi- 
tion before  the  law  and  mankind.  But  I  have  always  reached  the  same 
sad  conclusion,  that  when  one  enters  the  lists  in  behalf  of  anything,  he 
must  first  know  thoroughly,  and  be  able  to  explain,  that  for  which  he 
contends.     And  who  is  to-day  able  to  perfectly  explain  and  define  con- 


EFFEMINATION   AND   VlRAGINlTT.  293 

trary  sexual  instinct  ?  Yet  there  must  be  some  correct  explanation  of 
it;  there  must  be  some  way  in  which  the  mass  of  mankind  can  be 
brought  to  a  milder  and  more  reasonable  judgment  of  it;  and,  first  of 
all,  there  must  be  some  way  to  show  that  contrary  sexual  instinct  should 
not  be  regarded  as  meaning  the  same  as  pederasty,  as  the  majority  of 
men — I  may  say  all — regard  it.  By  such  an  act  a  man  might  erect  for 
himself  an  immortal  monument  in  the  gratitude  of  thousands  of  men  of 
present  and  future  generations;  for  there  have  been,  are,  and  will  ever 
be,  urnings,  and  in  greater  number  than  perhaps  has  been  suspected. 

"  In  Wilbrand's  work, '  Fridolin's  Secret  Marriage,'  I  find  a  very 
plausible  theory  given  in  explanation  of  this  matter ;  for  I  myself  have 
repeatedly  had  opportunity  to  observe  that  all  urnings  do  not  love  men 
with  the  same  intensity,  but  that  there  are  innumerable  sub- varieties, — 
from  the  most  feminine  man  to  the  man  of  contrary  sexuality  who  is 
equally  sensitive  to  female  charms.  This  may  also  account  for  the  so- 
called  difference  between  congenital  and  acquired  contrary  sexual  instinct, 
which,  in  my  inadequate  opinion,  does  not  exist.  Yet,  in  all  the  fifty -five 
individuals  I  have  become  .acquainted  with  in  the  three  years  since  I  came 
to  understand  this  matter,  I  have  met  the  same  peculiarities  of  tempera- 
ment, disposition,  and  character.  Almost  all  of  them  are  more  or  less 
idealists :  they  smoke  but  little,  or  not  at  all ;  they  are  bigoted,  vain, 
desirous  of  admiration,  and  superstitious ;  and,  unfortunately,  I  must 
confess  that  they  combine  more  the  defects  and  the  reverse  sides  of  both 
sexes  than  their  good  qualities.  For  woman  in  a  sexual  role  I  expe- 
rience a  feeling  of  true  horror,  which  I  could  never  overcome,  even  with 
the  help  of  my  extremely  lively  imagination.  I  have  never  attempted  it, 
because  I  am  thoroughly  convinced  of  the  fruitlessness  of  such  an 
attempt,  that  seems  to  me  unnatural  and  sinful. 

"  In  purely  social  and  friendly  relations,  I  like  to  associate  with 
ladies  and  girls,  and  I  am  gladly  welcomed  in  ladies'  society  ;  for  I  am 
much  interested  in  the  fashions  for  ladies,  and  know  how  to  talk  of  such 
things  with  great  skill.  When  I  wish  to,  I  can  be  very  gay  and  amiable ; 
but  my  faculty  for  conversation  is,  for  the  most  part,  only  assumed,  and 
it  always  tires  me.  I  have  always  had  great  skill  in  female  work,  and 
shown  interest  in  it.  As  a  child,  and  up  to  my  thirteenth  jear,  I  was 
passionately  fond  of  playing  with  dolls,  whose  clothes  I  made  myself; 
and  it  still  affords  me  much  pleasure  to  work  at  beautiful  embroidery, 
which,  unfortunately,  I  can  do  only  in  secret.  I  have  the  same  prefer- 
ence for  knick-knacks,  photographs,  flowers,  sweetmeats,  toilet-articles, 
and  such  feminine  things  ;  and  my  room,  which  I  arranged  and  decorated 
myself,  is  like  the  over-crowded  boudoir  of  a  lad}-. 

"  As  particular^-  remarkable,  I  wish  still  to  mention  that  I  have 
never  suffered  with  pollutions.  I  dream  very  much,  and  intensely, 
almost  every  night ;  occasionally  I  have  lascivious  dreams,  which  have 
only  men  as  subjects,  but  I  always  wake  out  of  them  before  it  comes  to 


294  fSYCHOPATHIA   SEXTJALIS. 

ejaculation.  In  reality  I  am  not  very  passionate  sexually,  and  I  have 
periods  lasting  from  four  to  six  weeks,  in  which  I  have  almost  no  sexual 
desire.  Unfortunately,  these  periods  are  infrequent,  and  they  are  usually 
followed  by  an  awakening  of  my  intense  sexual  desire  that  is  only  the 
more  violent;  which,  when  it  is  unsatisfied,  causes  intense  physical  and 
mental  suffering.  I  then  become  moody,  depressed,  sensitive,  irritable, 
and  retiring;  peculiarities,  however,  which,  with  the  first  opportunity  I 
have  for  sexual  gratification,  again  disappear.  I  must  mention,  also, 
that  often,  on  the  slightest  occasion,  my  mood  may  change  several  times 
during  the  day;  it  is  like  April  weather. 

"  I  dance  well,  and  like  to  ;  but  I  love  dancing  only  for  its  rhythmi- 
cal movement,  and  because  of  my  partiality  for  music. 

"  In  conclusion,  I  wish  to  speak  of  something  that  always  arouses 
repugnance  in  me.  We  are  usually  considered  diseased,  and  that  is 
absolutely  incorrect.  For  in  every  disease  there  is  a  means  of  cure 
or  amelioration ;  but  no  power  in  the  world  can  take  from  an  urning  his 
perverse  natural  constitution.  Even  suggestion,  which  has  been  used 
wi^h  so  much  apparent  success,  cannot  induce  any  enduring  change  in 
the  mental  life  of  an  urning.  In  us,  effect  is  mistaken  for  cause.  We 
are  considered  diseased,  because  in  time  the  majority  of  us  really  become 
ill.  I  am  almost  convinced  that  two-thirds  of  us,  in  later  life,  when  we 
really  live  so  long,  have  a  mental  defect  of  one  kind  or  another ;  and 
this  is  only  too  easily  explained.  For,  what  strength  of  will  and  nerves 
is  required  for  one  to  constantly  dissimulate,  lie,  and  play  the  hypocrite  all 
his  life !  How  often  in  the  society  of  normal  men,  when  the  conversation 
turns  to  contrary  sexual  instinct,  must  one  agree  with  the  words  of  abuse 
and  contempt,  while  every  one  of  them  wounds  the  heart.  On  the 
other  hand,  there  are  always  the  tiresome  and  indecent  jokes  and  talk 
about  women,  etc.,  that  must  be  heard ;  and  which  to-day,  in  so-called 
'  good  society,'  are  popular — and  to  show  interest  and  give  attention  to 
them !  Daily  and  hourly  to  see  so  many  handsome  men  to  whom  one 
cannot  reveal  himself;  to  be  compelled  to  go  without  a  friend,  inter- 
course with  whom  we  desire  so  much ;  and  besides,  constantly  the  fear- 
ful anxiety  of  betraying  one's  self  before  the  eyes  of  the  world,  and  then 
standing  covered  with  ignominy  and  shame !  It  is  really  no  wonder  that 
the  majority  of  us  are  incapable  of  real  work ;  for  we  need  all  our 
strength  of  will  and  power  of  endurance  for  the  struggle  with  our  own 
fate.  How  injurious  it  is  to  our  nerves  constantly  to  be  compelled  to 
shut  up  all  these  thoughts  and  feelings  in  our  hearts ;  where  our  lively 
fancy,  feeding  on  it  all,  plays  all  the  more  intensely,  so  that  we  go  about 
with  a  burning  fire  within  us  that  only  too  often  threatens  to  consume  us  1 
Happy  are  those  of  us  that  are  never  denied  the  strength  to  lead  such  a 
life ;  but  those,  too,  are  happy  that  have  passed  beyond  it." 

Case  123.  Autobiography.  "  In  what  follows,  you  will  find  the  de- 
scription of  the  character,  as  well  as  the  mental  and  sexual  disposition, 


EFFEMINATION   AND   VIRAGINITY.  295 

of  an  urning, — i.e.,  of  an  individual  who,  in  spite  of  his  masculine  form, 
feels  as  a  woman,  whose  senses  women  do  not  excite,  and  whose  sexual 
desires  are  constantly  directed  toward  men. 

"  Convinced  that  the  enigma  of  our  existence  can  be  solved,  or,  at 
least,  illuminated,  only  by  the  unprejudiced  thought  of  scientific  men,  I 
describe  my  life  only  with  the  aim  of  perhaps  clearing  up  this  cruel  error 
of  Nature,  and  possibly  doing  a  kindness  to  people  like  me  to  come  in  later 
generations ;  for  there  will  be  urnings  as  long  as  men  are  born,  just  as  it 
is  a  fact  that  they  have  existed  in  every  age.  With  the  progress  of 
science  in  our  epoch,  men  will  see  in  me  and  those  like  me  not  objects  of 
hatred,  but  objects  of  pity,  which  deserve  not  the  odium,  but  the  com- 
passion, of  their  more  fortunate  brothers.  I  shall  be  as  brief  as  possible 
in  my  communication,  and  also  objective;  and,  with  reference  to  my 
caustic,  often  cynical,  style,  I  may  note  that,  above  all,  I  shall  be  honest, 
and,  therefore,  not  avoid  strong  expressions  ;  for  they  are  most  happily 
suited  to  the  subject  in  hand. 

"I  am  in  my  thirty -fifth  year;  a  merchant,  with  a  fair  income; 
somewhat  above  average  height,  slim,  weak  of  muscle,  with  full  beard,  and 
quite  ordinary  face,  and,  at  first  sight,  in  nowise  different  from  ordinary 
men.  On  the  other  hand,  my  gait  is  feminine,  and  particularly  mincing 
in  fast  walking ;  the  movements  are  awkward  and  displeasing,  indicative 
of  a  want  of  manly  feeling.  The  voice  is  neither  feminine  nor  shrill,  but 
rather  a  baritone. 

"  This  is  my  external  appearance. 

"  I  do  not  smoke  or  drink,  and  can  neither  whistle,  ride,  do  gym- 
nastic feats,  fence,  nor  shoot.  I  have  absolutely  no  interest  in  horses  or 
dogs,  and  have  never  had  a  gun  or  sword  in  my  hand.  In  inner  feeling 
and  sexual  desire,  I  am  completely  a  woman.  Without  thorough  educa- 
tion,— I  passed  through  but  few  classes  in  the  Gymnasium, — I  am  yet 
intelligent,  like  to  read  well-written,  improving  books,  and  have  good 
judgment ;  but  I  allow  myself  to  be  carried  away  by  the  feelings  of  the 
moment,  and  I  am  easily  influenced  by  any  one  who  knows  my  weakness 
and  how  to  make  use  of  it.  Constantly  making  resolves,  I  have  never 
the  energy  to  carry  them  out ;  like  a  woman,  I  am  moody  and  nervous, 
often  irritated  without  reason,  and  sometimes  mean.  Toward  persons 
that  do  not  please  me,  I  am  arrogant,  unjust,  and  often  shamefully 
insulting. 

"  In  all  my  conduct  I  am  superficial,  and  often  frivolous,  and  I  have 
no  deep  moral  feeling.  I  have  little  consideration  for  parents  and 
brothers  and  sisters.  I  am  not  egotistic,  but,  on  occasion,  self-sacri- 
ficing. I  cannot  withstand  tears,  and  can — like  a  woman — be  won  by 
amiability  and  entreaty. 

"  In  my  earliest  years  I  avoided  playing  soldier,  gymnastics,  or  the 
rough  games  of  my  manly  comrades,  and  ran  about  with  little  girls,  with 
whom  I  was  much  more  in  sympathy  than  with  boys.     I  was  retiring, 


296  PSYCHOPATHIA   SEXUALIS. 

bashful,  and  often  blushing.  When  no  more  than  twelve  or  thirteen 
years  old,  the  close-fitting  uniform  of  a  handsome  soldier  gave  me  the 
most  peculiar  feeling ;  and  while,  during  the  next  few  }Tears,  my  comrades 
were  always  talking  about  girls,  and  even  engaged  in  love-affairs,  I  could, 
for  hours  at  a  time,  run  after  a  well-built  man  with  well-rounded  hips, 
and  feast  my  eyes  on  the  sight. 

"  Without  thinking  much  of  these  impressions,  so  different  from  the 
feelings  of  my  comrades,  I  began  to  masturbate,  always  during  the  act 
thinking  of  a  heroic,  handsome  form;  and  this  continued  until  my 
seventeenth  year,  when  I  learned  from  a  companion  constituted  like  my- 
self a  true  explanation  of  my  condition.  Since  that  time  I  have  been 
with  girls  eight  or  ten  times ;  but,  in  order  to  have  an  erection,  it  was 
always  necessary  to  think  of  a  handsome  man  of  my  acquaintance.  And 
I  am  thoroughly  convinced  that  to-day,  even  with  the  help  of  imagination, 
I  should  be  unable  to  have  intercourse  with  a  girl. 

"  Shortly  after  my  discovery  I  preferred  to  associate  with  mature, 
powerful  urnings  ;  for  at  this  time  I  had  neither  mind  nor  opportunity  to 
associate  with  real  men.  Since  this  my  taste  has  changed  entirely,  and 
men,  real  men,  of  twenty-five  or  thirtj'-five  years,  with  supple,  powerful 
forms,  are  the  only  ones  that  ravish  my  senses,  and  charm  me  as  if  I 
were  a  woman.  Circumstances  have  allowed  me,  during  these  years,  to 
make  about  a  dozen  male  acquaintances  that  would  serve  my  purpose  for 
a  gulden  or  two  a  visit.  If  I  am  alone  in  a  room  with  a  handsome  youth, 
my  greatest  pleasure  is  membrum  ejus  vel  maxime  si  magnum  atque 
crassum  est,  manibus  capere  et  apprehendere  et  premere,  turgentes  nates 
femoraque  tangere  atque  totum  corpus  manibus  contrectare  et,  si  con- 
ceditur,  os  faciem  atque  totum  corpus,  immovero  nates,  ardentibus 
osculis  obtegere.  Quodsi  membrum  magnum  purumque  est,  dominusque 
ejus  mihi  placet,  ardente  libidine  mentulam  ejus  in  os  meum  receptam 
complures  horas  sugere  possum,  neque  autem  delector,  si  semen  in  os 
meum  ejaculatur,  cum  maxima  eorum  qui  "  urnings  "  nominantur  pars 
hac  re  non  modo  delectatur,  sed  etiam  semen  nonnunquam  devorat. 

"  The  most  intense  delight,  however,  is  experienced  when  I  find  a 
real  man,  qui  membrum  meum  in  os  recepit  et  erectionem  in  ore  suo  con- 
cedit. 

"  Improbable  as  it  sounds,  I  am  yet  able  to  find  some  coarse  fellows 
who  will  allow  themselves  to  be  used  for  this  purpose.  They  learn  the 
thing  while  in  military  service,  for  urnings  know  that  under  such  circum- 
stances they  can  be  made  to  do  the  most  for  money ;  and  when  the  fel- 
lows are  once  trained,  circumstances  often  compel  them,  in  spite  of  their 
passion  for  the  opposite  sex,  to  continue  the  practice. 

"  With  certain  exceptions,  urnings  make  no  impression  on  me,  be- 
cause everything  feminine  is  repugnant  to  me.  At  the  same  time,  there  are 
some  that  know  how  to  give  me  the  most  intense  pleasure,  just  as  a  real 
man  can ;  and  I  prefer  to  consort  with  them,  for  the  reason  that  sometimes 


EFFEMINATION   AND   VIRAGINITY.  297 

they  return  my  passionate  caresses.  In  tete-a-tete  with  such  a  person,  I 
throw  all  check  from  my  excited  senses,  and  give  my  animal  passions  free 
rein,  osculor,  premo,  amplector  eum,  linguam  meam  in  os  ejus  immitto  ; 
ore  cupiditate  tremente  ejus  labrum  superius  sugo,  faciem  meam  ad  ejus 
nates  adpono  et  odore  voluptari  e  natibus  emanente  voluptate  obstupe- 
scor.  Real  men,  in  close-fitting  uniform,  make  the  deepest  impression  on 
me ;  and  if  I  have  an  opportunity  to  embrace  and  kiss  such  a  ravishing 
fellow,  ejaculation  takes  place  at  once, — a  weakness  which  I  attribute  to 
my  frequent  masturbation.  In  my  earlier  years  I  practiced  it  very  fre- 
quently, almost  every  time  I  saw  a  man  pleasing  to  me,  whose  image  I 
kept  before  my  eye  during  the  act.  For  this  my  taste  is  in  nowise  diffi- 
cult to  please — like  that  a  servant-girl  might  have  in  finding  her  ideal  in 
a  dragoon  guard.  A  handsome  face  is  a  pleasant  supplement,  inflaming 
my  sensual  desire,  but  in  no  respect  an  essential.  The  requisite  remains  : 
vir  inferiore  corporis  parte  robusta  et  bene  formosa,  turgidis  femoribus 
durisque  natibus,  while  the  upper  portion  of  the  bod}r  may  be  slim.  Cor- 
pulence disgusts  me.  A  sensual  mouth  with  pretty  teeth  affects  me  more 
intensely ;  and  if  the  person  has  also  a  membrum  pulchrum  magnum 
et  sequaliter  formatum,  all  my  demands — the  most  far-reaching — are 
fulfilled. 

"  When  I  was  younger,  with  men  that  pleased  me  and  excited  my 
passions  intensely,  ejaculation  took  place  from  five  to  eight  times  in  a 
night,  and  now  it  occurs  from  four  to  six  times ;  for  I  am  unusually 
strong  sensually,  and,  as  an  example,  even  the  clinking  of  a  hussar's 
sword  may  excite  me.  At  the  same  time,  I  have  a  very  lively  fancy,  and 
spend  most  of  my  leisure  hours  thinking  of  handsome  men  with  strong 
limbs ;  and  I  would  be  delighted  to  look  on  when  a  powerful  fellow,  using 
force,  magna  mentula  prseditus  me  praesente  puellam  futuat ;  mihi  per- 
suasum  est,  fore  ut  hoc  aspectu  sensus  mei  vehementissima  perturbatione 
afficiantur  et  dum  futuit  corpus  adolescentis  pulchri  tangam  et,  si  liceat, 
ascendam  in  eum  dum  cum  puella  concumbit  atque  idem  cum  eo  faciam  et 
membrum  meum  in  ejus  anum  immittam.  The  accomplishment  of  these 
cynical  ideas — with  which  my  mind  is  often  filled — is  hindered  only  by 
my  limited  means ;  otherwise,  I  should  long  ago  have  had  the  reality. 

"  Soldiers  have  the  greatest  charm  for  me,  but  I  have  also  a  weak- 
ness for  butchers,  fakirs,  drivers,  circus-riders,  and  boat-captains ;  and  all 
these  must  be  supple  and  powerfully  built.  Urnings  I  hate  in  intimate 
relation,  and  for  the  majority  of  them  I  have  an  inexplicable  and  unjust 
aversion.  I  have  never  had  but  one  urning  for  an  intimate  friend.  On 
the  other  hand,  the  most  affectionate  and  enduring  ties  bind  me  to  men  of 
my  own  age,  in  whose  company  I  delight,  but  with  whom  I  have  no 
sexual  relations,  and  who  have  no  idea  of  my  condition. 

"  Talk  on  politics  and  economics,  like  every  other  earnest  subject,  I 
hate  ;  though  I  gossip  with  considerable  sense  and  peculiar  pleasure  about 
the  theatre.     At  operas  I  see  myself  on  the  stage,  feel  myself  applauded 


298  PSYCHOPATHtA  SEXUALIS. 

by  the  public,  and  would  prefer  to  sing  as  a  passive  heroine,  or  in  the 
dramatic  role  of  a  woman. 

"  The  most  interesting  subject  of  conversation  for  me,  and  those 
like  me,  is,  however,  always — men ;  for  us  this  is  inexhaustible.  Their 
secret  charms  are  described  in  the  most  minute  details,  mentulse  sestiman- 
tur,  quanta  sint  magnitudine,  quanta,  crassitudine ;  de  forma  earum  atque 
rigiditate  conferimus,  alter  ab  altero  cognoscit  cujus  semen  celerius,  cujus 
tardius  ejaculetur.  I  may  add  that,  of  my  four  brothers,  one  gave  himself 
to  the  service  of  urnings,  without  himself  being  one ;  and  all  four  are 
ladies'  men,  and  indulge  in  sexual  excesses.  The  genitals  of  the  men  of 
our  family  are,  without  exception,  unusually  developed. 

"  In  conclusion,  I  repeat  the  words  with  which  I  began  these  lines. 
I  could  not  choose  my  expressions,  because  my  object  in  the  foregoing 
has  been  to  afford  material  for  the  study  of  the  urning's  existence,  and 
absolute  truth  was  essential.  I  beg  the  numerous  cynics  to  keep  this 
circumstance  in  mind." 

In  October,  1890,  the  writer  of  the  foregoing  lines  presented  himself 
to  me.  In  all  essentials  his  appearance  corresponded  with  his  description. 
Genitals  large,  with  abundant  growth  of  hair.  His  parents  had  been 
well  nervously.  One  brother  had  shot  himself  on  account  of  nervous 
trouble ;  three  others  were  intensely  nervous.  The  patient  came  to  me 
in  a  state  of  despair.  He  could  not  endure  such  a  life  any  longer ;  for 
he  had  been  admonished  about  intercourse  with  men  that  could  be 
bought ;  and  with  his  extreme  sensual  nature  he  was  unable  to  abstain. 
Too,  he  could  not  understand  how  he  could  be  made  to  love  women, 
and  enjoy  the  nobler  joys  of  life.  He  had  had  love  for  men  since  his 
thirteenth  year. 

He  felt  in  all  respects  like  a  woman,  and  longed  to  be  won  by  men 
that  were  not  urnings.  When  he  was  with  an  urning,  it  was  just  as  if 
two  girls  were  together.  He  would  prefer  being  sexless  to  living  longer 
as  he  was.     Would  not  castration  help  him  ? 

An  attempt  at  hypnosis  with  the  highly  excited  patient  induced 
only  a  very  slight  degree  of  lethargy. 

Case  124.  B.,  waiter,  aged  42,  single,  was  sent  to  me  by  his  phy- 
sician, with  whom  he  was  in  love,  as  one  who  was  suffering  from  contrary 
sexual  feeling.  B.  very  willingly,  and  in  a  decent  manner,  gave  a  history 
of  his  past  life,  especially  of  his  sexual  life,  and  was  glad  at  least  to  have 
an  authoritative  opinion  concerning  his  sexual  condition,  which  had 
always  appeared  to  him  abnormal. 

B.  knew  nothing  to  report  of  his  grandparents.  His  father  had 
been  a  passionate,  excitable  man,  a  drinker,  and  always  very  sensual. 
After  he  had  begotten  twenty -four  children  by  one  wife,  he  was  divorced 
from  her ;  and  after  that  his  landlady  became  three  times  pregnant  by 
him.     His  mother  was  healthy. 

Of  the  twenty-three  children,  but  six  were  living;   several  were 


EFFEMINATION   AND   VIRAGINITT.  299 

nervous,  but  not  sexually  abnormal,  with  the  exception  of  one  sister,  who 
always  sought  men. 

B.  asserts  that  from  childhood  he  was  sickly.  At  eight  his  sexual 
life  began.  He  masturbated,  and  became  possessed  of  the  idea  penem 
aliorum  puerorum  in  os  arrigere,  which  gave  him  the  greatest  pleasure. 
At  twelve  he  began  to  fall  in  love  with  men,  usually  with  those  between 
thirty  and  forty,  with  moustaches.  Even  at  that  time  his  sexual  desire 
was  greatly  developed,  and  he  had  erections  and  pollutions.  From  that 
time,  indeed,  he  masturbated  daily,  and  during  the  act  thought  of  a  beloved 
man.  Yet  his  greatest  delight  had  been  penem  viri  in  os  arrigere.  During 
the  act  he  had  ejaculation,  with  an  intense  feeling  of  pleasure.  Only  about 
twelve  times  had  he  had  this  pleasure.  He  had  never  felt  disgust  with 
the  penis  of  another  sympathetic  man ;  quite  the  contrary.  He  had  never 
accepted  proffers  of  pederasty;  actively  or  passively,  it  was  very  dis- 
gusting to  him.  In  the  perverse  sexual  act  he  had  always  thought  of 
himself  in  the  role  of  a  woman.  His  passion  for  men  in  sympathy  with 
him  had  been  unbounded.  He  would  have  done  everything  for  a  lover ; 
even  at  the  sight  of  him  he  would  tremble  with  excitement  and  joy. 

At  nineteen  he  often  allowed  himself  to  be  taken  by  his  comrades 
to  houses  of  prostitution.  He  never  had  pleasure  in  coitus,  and  only  in 
the  moment  of  ejaculation  felt  satisfaction.  In  order  to  get  an  erection 
with  a  woman,  it  was  always  necessary,  in  the  act,  for  him  to  think  of  a 
beloved  man.  He  would  always  have  preferred  to  have  the  woman  allow 
immissio  penis  in  os,  which,  however,  was  always  denied  him.  Faute  de 
mieux,  he  had  practiced  coitus,  and,  indeed,  twice  became  a  father.  The 
last  child,  a  girl  of  eight,  had  already  begun  to  practice  masturbation  and 
mutual  onanism,  which  troubled  him  very  much  as  a  father.  He  wished 
to  know  whether  there  was  any  remedy  for  it. 

The  patient  asserted  that  he  always  felt  himself  toward  men  in  a 
feminine  role  (also  in  sexual  intercourse).  He  had  always  thought  that 
his  sexual  perversion  had  resulted  from  his  father's  wishing  to  beget  a 
girl  when  he  begat  him.  His  brothers  and  sisters  had  always  joked  him 
on  account  of  his  feminine  manners.  Sweeping  and  house-cleaning  had 
always  been  pleasant  occupations  for  him.  His  activities  in  this  direc- 
tion had  often  been  wondered  at,  and  he  was  considered  more  skillful 
than  a  girl.  Whenever  he  could,  he  dressed  like  a  woman.  At  the 
carnival  he  appeared  at  the  dances  masked  as  a  female.  He  was  very 
successful  at  coquetry  on  such  occasions,  because  he  had  a  feminine 
nature. 

He  had  never  had  real  pleasure  in  drinking,  smoking,  or  in  mascu- 
line occupations  or  pleasures ;  but,  on  the  other  iiand,  he  loved  to  sew, 
and  as  a  child  had  often  been  scolded  for  his  playing  with  dolls.  His 
interest  at  the  circus  or  theatre  was  confined  to  men.  Frequently  he 
could  not  overcome  the  impulse  to  hang  around  water-closets,  in  order  to 
get  sight  of  male  genitals. 


300  PSYCHOPATHIA   SEXUALIS. 

Feminine  charms  had  never  pleased  him.  Coitus  had  been  possible 
only  when  he  thought  of  a  beloved  man.  Nocturnal  pollutions  were 
always  induced  by  lascivious  dreams  of  men. 

In  spite  of  much  sexual  excess,  B.  had  never  suffered  from  neuras- 
thenia sexualis,  and,  besides,  there  was  not  a  symptom  of  neurasthenia 
discoverable  in  him. 

Patient  is  delicate,  and  his  whiskers  and  moustache,  which  made 
their  appearance  in  his  twenty-eighth  year,  are  thin.  Externally,  with 
the  exception  of  a  weaving  gait,  he  presents  nothing  which  would 
point  to  his  feminine  nature.  He  asserts  that  he  has  often  been  joked 
about  his  feminine  gait.  His  conduct  is  in  all  respects  decent.  His 
genitals  are  large,  well  developed,  and  normal  in  all  respects,  and  the 
growth  of  genital  hair  is  abundant ;  the  pelvis  is  masculine.  The  head  is 
rachitic,  somewhat  hydrocephalic,  with  prominence  of  the  parietal  bones. 
The  face  is  remarkably  small.  The  patient  says  that  he  is  irritable  and 
easily  angered. 

Case  125.  On  May  1,  1880,  G.,  Ph.D.,  and  a  writer,  was  brought 
to  the  clinic  for  mental  diseases,  at  Graz,  by  the  public  authorities. 
While  on  his  return  from  Italy,  G.  found  a  soldier  in  Graz  who  gave 
himself  up  to  him  for  hire,  but  ultimately  denounced  G.  to  the  police, 
because  G.  had  openly  confessed  his  love  for  men.  The  authorities  con- 
sidered his  mental  condition  doubtful,  and  sent  him  to  alienists  for 
examination.  To  the  physicians  G.  related,  with  cynical  openness,  that 
years  before,  in  M.,  he  had  had  just  such  an  affair  with  the  police,  and  was 
in  prison  fourteen  days.  In  the  South  there  was  no  danger  from  such 
people ;  it  was  only  in  Germany  and  Austria  that  the  thing  was  regarded 
as  an  evil. 

G.  is  fifty  years  old,  tall,  powerful,  and  has  a  numerous  expression, 
and  a  cynical,  coquettish  manner ;  the  eye  has  a  neuropathic,  swimming 
expression ;  the  teeth  of  the  under  jaw  stand  far  back  from  those  of  the 
upper  jaw.  The  cranium  is  normal,  the  voice  masculine,  and  the  beard 
abundant.  The  genitals  are  well  formed,  though  the  testicles  are  some- 
what small.  With  the  exception  of  slight  emphysema  of  the  lungs  and 
external  fistula  in  ano,  there  are  no  remarkable  anomalies  of  the  vegeta- 
tive organs.  G.'s  father  was  subject  to  periodical  insanity.  His  mother 
was  a  high-strung  person,  and  she  had  an  insane  sister.  Of  the  children, 
four  died  in  childhood. 

With  the  exception  of  scrofulosis,  G.  asserts  that  he  was  healthy. 
He  obtained  the  degree  of  Doctor  of  Philosophy ;  at  twenty-five,  he  had 
haemoptysis,  and  went  to  Italy,  where  he  has  since  lived,  with  slight 
interruption,  by  writing  and  by  giving  private  lessons.  G.  says  that  he 
often  has  congestions,  and  also  some  spinal  irritation, — i.e.,  pain  in  his 
back, — but  otherwise  he  has  a  genial  disposition ;  only  he  is  not  much  of 
a  financier ;  and  at  the  same  time,  like  all  old  prostitutes,  he  has  a  very 
good  appetite.    Further,  he  states,  with  great  satisfaction  and  remarkable 


EFFEMINATION   AND   VIRAGINITY.  301 

cynicism,  that  he  has  congenital  contrary  sexual  instinct.  When  only 
five  years  old,  it  was  his  greatest  pleasure  to  get  sight  of  a  penis,  and  he 
hung  about  appropriate  places,  in  order  to  enjoy  that  pleasure.  Even 
before  puberty  he  practiced  masturbation.  At  the  time  of  puberty  he 
noticed  an  inward  feeling  for  friends.  An  obscure  impulse  pointed  out 
to  him  the  way  his  love  would  take.  He  was  actually  impelled  to  kiss 
young  men,  and  now  and  then  to  caress  their  genitals.  When  twenty- 
six  years  old,  he  first  began  to  have  sexual  intercourse  with  men,  toward 
whom  he  felt  like  a  woman.  Even  as  a  child,  it  was  his  greatest  delight 
to  put  on  female  attire.  He  was  often  chastised  by  his  father  because, 
in  the  effort  to  satisfy  this  impulse,  he  put  on  his  sister's  clothing. 
If  he  happened  to  see  a  ballet,  only  the  male  dancers  interested  him. 
Since  he  could  remember,  he  had  had  a  horror  feminse.  If  he  happened  to 
visit  a  brothel,  it  was  only  to  see  young  men.  He  was,  indeed,  a  rival  of 
prostitutes.  If  he  saw  a  young  man,  he  just  looked  at  his  eyes ;  in  case 
these  pleased  him,  then  came  the  mouth — whether  it  was  well  formed  for 
kissing  ;•  then  he  would  look  at  the  genitals — whether  they  were  well 
developed.  G.  pointed,  with  great  feeling  of  self-satisfaction,  to  his  poeti- 
cal works,  and  tried  to  make  it  appear  that  persons  with  natures  like  his 
were  poetically  endowed.  He  gave  as  examples  Yoltaire,  Frederick  the 
Great,  Eugene  of  Savoy,  and  Plato,  as  well  as  numerous  distinguished 
men  of  the  present,  who,  according  to  his  opinion,  were  urnings.  His 
greatest  pleasure  was  to  have  a  sympathetic  young  man  read  his  verses 
to  him.  During  the  last  summer  he  had  had  such  a  lover.  When 
he  had  to  part  with  him,  he  was  quite  undone,  and  he  did  not  eat  or  sleep 
until  gradually  he  had  regained  his  former  condition.  He  said  that  the 
love  of  urnings  was  a  passionate,  inner  fire.  According  to  his  statement, 
in  Naples  the  effeminelli  lived  in  a  quarter  together,  just  as  in  Paris  the 
grisettes  live  with  their  lovers.  They  sacrifice  themselves  for  their  lovers, 
and  care  for  the  household,  just  as  the  grisettes  do.  On  the  other  hand, 
an  urning  repels  an  urning,  "just  as  one  prostitute  does  another — that  is 
the  curse." 

The  need  of  intercourse  with  males  occurs  about  once  a  week  with 
G.  He  is  happy  in  his  peculiar  sexuality,  which  he,  it  is  true,  considers 
peculiar,  but  which  he  will  not  regard  as  abnormal  or  wrong.  He  thinks 
that  nothing  remains  for  him  and  those  like  him  but  to  raise  what  is  un- 
natural in  themselves  to  the  supernatural.  He  looks  upon  the  love  of 
urnings  as  the  higher,  the  ideal,  as  godlike,  an  abstract  love.  When 
shown  that  such  a  love  is  far  from  the  purpose  of  Nature  and  the  preser- 
vation of  the  race,  he  expresses  the  pessimistic  thought  that  the  world 
should  die  out,  and  the  earth  turn  round  its  axis  without  men,  who  were 
on  it  only  for  trouble.  As  reason  and  explanation  of  his  unnatural 
sexual  feeling,  G.  refers  to  Plato,  "  who  certainly  was  no  beast."  Plato 
expressed  allegorically  the  idea  that  men  were  originally  balls.  The 
gods  had  divided  these  into  two   hemispheres,     For  the  most  part, 


302  PSYCHOPATHIA    SEXUALIS. 

man  is  suited  to  woman,  but  sometimes  man  to  man.  In  the  latter  case, 
the  impulse  to  union  is  quite  as  powerful  as  in  the  former,  and  they 
strengthen  each  other  in  the  same  way.  G.  further  relates  that  his 
dreams,  when  they  were  erotic,  never  had  women,  but  only  men,  for  their 
subjects.  Male-love  was  the  only  kind  that  could  satisfy  him.  He  con- 
sidered it  disgusting  for  one  human  being  to  be  prodding  about  in  the 
abdomen  of  another  with  his  penis,  since  he  had  heard  that  in  this  dis- 
gusting fashion  coitus  was  usually  carried  out.  He  had  never  had  the 
curiosity  to  inform  himself  concerning  the  female  genitals ;  the  subject 
was  disgusting  to  him.  The  indulgence  of  his  sexual  appetite  he  did  not 
consider  a  vice,  but  the  result  of  a  natural  impulse  which  compelled  him 
to  it.  It  conduced  to  self-preservation.  Onanism  was  a  poor  substitute, 
and,  moreover,  injurious,  while  urnin<^k>ve  was  morally  elevating  and 
conducive  to  physical  well-being. 


With  moral  indignation,  which 


in  contrast  with  his  cynicism  in 


other  directions  appeared  ridiculous,  ne  protested  against  the  classifica- 
tion of  urnings  with  those  who  indulged  in  pederasty.  He  looked  on  the 
podex  with  disgust,  as  it  was  a  secreting  organ.  The  intercourse  of 
urnings  always  took  place  in  front,  and  was  combined  onanism. 

This  was  the  extent  of  G.'s  disclosures,  whose  mental  condition  was 
certainly  congenitally  abnormal.  As  proof  of  this,  may  be  cited  his 
cynicism ;  his  incredible  frivolity  in  his  application  of  his  vices  to  re- 
ligion, in  which  direction  we  cannot  follow  him  without  overstepping  the 
bounds  set  by  scientific  inquiry ;  his  perverse  philosophical  ideas  with 
reference  to  his  sexual  perversion ;  his  perverse  manner  of  looking  at  the 
world ;  his  ethical  defect  in  all  directions  ;  his  vagabondage ;  and  his  per- 
verse mind  and  exterior.  G.  makes  the  impression  of  an  original 
paranoiac.     (Personal  case.     Zeitschrift  fur  Psychiatrie.) 

Case  126.  Taylor  had  occasion  to  examine  a  certain  Eliza  Edwards, 
aged  24.  It  was  discovered  that  she  was  of  masculine  sex.  E.  had  worn 
female  clothing  from  her  fourteenth  year,  and  also  been  an  actress.  The 
hair  was  worn  long  after  the  manner  of  females,  and  parted  in  the  middle. 
The  form  of  the  face  was  feminine,  but  otherwise  the  body  was  masculine. 
The  beard  was  carefully  pulled  out.  The  masculine,  well-developed  geni- 
tals were  fixed  in  an  upward  position  by  an  artful  bandage.  The  con- 
dition of  the  anas  indicated  passive  pederasty. 

Case  121.  An  official  of  middle  age,  who  for  some  years  had  been 
happy  in  family  life,  and  was  married  to  a  virtuous  woman,  presented  a 
peculiar  manifestation  of  contrary  sexual  feeling. 

One  day,  through  the  indiscretion  of  a  prostitute,  the  following 
scandal  became  public :  About  once  a  week  X.  would  appear  in  a  house 
of  prostitution,  and  there  dress  himself  up  as  a  woman,  always  requiring, 
as  a  part  of  his  costume,  a  coiffure.  When  his  toilet  was  completed,  he 
would  lie  down  on  the  bed,  and  have  the  prostitute  perform  manustupra- 
tion.     But  he  very  much  preferred  to  have  a  male  person  (a  servant  of 


EFFEMINATION   AND   VIRAGINITY.  303 

the  house).  This  man's  father  was  hereditarily  tainted,  had  been  insane 
several  times,  and  was  afflicted  with  hyperesthesia  and  paresthesia 
sexualis. 

Case  128.  C.  R.,  maid-servant,  aged  26,  suffered  from  the  time  of 
her  development  with  original  paranoia  and  hysteria.  As  a  result  of  her 
delusions,  her  life  had  been  somewhat  romantic,  and  in  1884,  in  Switzer- 
land, where  she  had  gone  as  a  result  of  delusions  of  persecution,  she  came 
under  the  observation  of  the  authorities.  On  this  occasion,  it  was  ascer- 
tained that  R.  was  affected  with  contrary  sexual  instinct. 

Concerning  her  parents  and  relatives  there  is  no  information  at 
hand.  R.  asserted  that,  with  the  exception  of  an  inflammation  of  the 
lungs  at  the  age  of  sixteen,  she  had  never  been  severely  ill. 

First  menstruation  at  fifteen,  without  any  difficulties ;  thereafter  it 
was  very  often  irregular  and  abnormally  excessive.  The  patient  declared 
that  she  never  had  had  inclinations  toward  the  opposite  sex,  and  had  never 
allowed  the  approach  of  a  man.  She  never  could  understand  how  her 
friends  could  describe  the  beaut}r  and  amiability  of  men.  But  it  was 
charming  and  inspiring  for  her  to  imprint  a  kiss  on  the  lips  of  a  beloved 
female  friend.  She  had  a  love  for  girls  that  was  incomprehensible  to  her. 
She  had  passionately  loved  and  kissed  some  of  her  female  friends,  and 
she  would  have  given  up  her  life  for  them.  Her  greatest  delight  would 
have  been  to  have  constantly  lived  with  such  a  friend  and  absolutely 
possessed  her. 

In  this  she  felt  toward  the  beloved  girl  like  a  man.  Even  as  a 
little  child,  she  had  an  inclination  only  for  the  play  of  boys,  and  she 
loved  to  hear  shooting  and  military  music,  was  always  much  excited  by 
them,  and  would  gladly  have  gone  as  a  soldier,  f  The  chase  and  war  have 
been  her  ideals.  In  the  theatre  only  feminine  performers  interested  her. 
She  knew  very  well  that  the  whole  of  this  inclination  was  unwomanly,  but 
she  could  not  help  it.  It  had  always  been  a  great  pleasure  for  her  to  go 
about  in  male  elothing,  and  in  the  same  way  she  had  always  preferred 
masculine  work,  and  had  shown  unusual  skill  in  it;  while  with  refer- 
ence to  feminine  occupations,  especially  handiwork,  she  had  to  say  the 
contrary.  The  patient  had  also  a  weakness  for  smoking  and  spirits.  On 
account  of  persecutory  delusions,  in  order  to  rid  herself  of  her  persecu- 
tions, the  patient  had  often  gone  about  in  male  attire,  and  played  the 
part  of  a  man.  She  did  this  with  such  (congenital)  skill  that,  as  a  rule, 
she  was  able  to  deceive  people  concerning  her  sex. 

It  is  authoritatively  established  that  in  1884,  for  a  long  time,  the 
patient  went  about  in  male  attire,  now  in  the  garments  of  a  civilian,  now 
in  the  uniform  of  a  lieutenant;  and  in  August  of  the  same  year,  dressed 
as  a  male  servant,  she  fled  to  Switzerland  as  a  result  of  delusions  of  per- 
secution. There  she  found  service  in  a  merchant's  family,  and  fell  in  love 
with  the  daughter  of  the  house,  "  the  beautiful  Anna,"  who,  on  her  side, 
not  recognizing  the  sex  of  R.,  fell  in  love  with  the  handsome  young  man. 


304  PSYCHOPATHIA   SEXUALIS. 

Concerning  this  episode  the  patient  makes  the  following  character- 
istic statement :  "  I  was  madly  in  love  with  Anna.  I  don't  know  how  it 
came  about,  and  I  cannot  put  myself  right  concerning  this  impulse.  In 
this  fatal  love  lies  the  reason  why  I  played  the  role  of  a  man  so  long.  I 
have  never  jTet  felt  any  love  for  a  man,  and  I  believe  that  my  love  is  for  the 
female  and  not  the  male  sex.    I  can  in  nowise  understand  my  condition." 

From  Switzerland  R.  wrote  letters  home  to  her  friend,  Amelia, 
which  were  produced  at  the  examination.  They  are  letters  showing  pas- 
sionate love,  which  goes  beyond  the  bounds  of  friendship.  She  apostro- 
phizes her  friend,  "  My  flower,  sun  of  my  heart,  longing  of  my  soul." 
She  was  her  greatest  happiness  on  earth  ;  her  heart  was  hers.  And  in  her 
letters  to  her  friend's  parents  she  wrote :  "  You,  too,  should  watch  your 
flower,  for,  if  she  should  die,  you  also  would  be  unable  to  endure  life." 

For  the  purpose  of  investigating  her  mental  condition,  R.  remained 
for  some  time  in  an  asylum.  On  one  occasion,  when  Anna  was  allowed 
to  pay  R.  a  visit,  there  was  no  end  of  passionate  embraces  and  kisses. 
The  visitor  acknowledged  freely  that  they  had  before  secretly  embraced 
and  kissed  in  the  same  way. 

R.  is  a  tall,  slim,  stately  person,  of  feminine  form  in  all  respects, 
but  with  masculine  features.  Cranium  regular ;  no  anatomical  signs  of 
degeneration.  Genitals  normal  and  indicative  of  virginity.  All  the 
circumstances  indicate  that  she  has  only  indulged  in  platonic  love. 
Glance  and  appearance  are  indicative  of  a  neuropathic  person.  Severe 
hysteria,  occasional  cataleptoid  attacks,  with  visional  and  delirious 
states.  The  patient  is  very  easily  brought  into  a  state  of  somnambulism 
by  hypnotic  influence,  and  in  this  condition  is  susceptible  to  all  possible 
suggestions.     (Personal  case.     Friedreich's  Blatter,  1886,  Heft  1.) 

4.  Androgyny  and  Oynandry. — Forming  direct  transitions 
from  the  foregoing  groups  are  those  individuals  of  contrary  sex- 
uality in  whom  not  only  the  character  and  all  the  feelings  are  in 
accord  with  the  abnormal  sexual  instinct,  but  also  the  skeletal 
form,  the  features,  voice,  etc. ;  so  that  the  individual  approaches 
the  opposite  sex  anthropologically,  and  in  more  than  a  psychical 
and  psycho-sexual  way.  This  anthropological  form  of  the  cere- 
bral anomaly  apparently  represents  a  very  high  degree  of  degen- 
eration ;  but  that  this  variation  is  based  on  an  entirely  different 
ground  than  the  teratological  manifestation  of  hermaphroditism, 
in  an  anatomical  sense,  is  clearly  shown  by  the  fact  that  thus  far, 
in  the  domain  of  contrary  sexuality,  no  transitions  to  hermaph- 
roditic malformation  of  the  genitals  have  been  observed.  The 
genitals  of  these  persons  always  prove  to  be  fully  differentiated 


ANDROGYNY    AND   GYNANDRY.  305 

sexually,  though  not  infrequently  there  are  present  anatomical 
signs  of  degeneration  (epispadiasis,  etc.),  in  the  sense  of  arrests 
of  development  in  organs  that  are  otherwise  well  differentiated. 

There  is  yet  wanting  a  sufficient  record  of  cases  belonging 
to  this  interesting  group  of  women  in  masculine  attire  with  mas- 
culine genitals,  and  men  in  feminine  dress  with  the  sexual  or- 
gans of  the  female.  Every  experienced  observer  of  his  fellow-men 
remembers  masculine  persons  that  were  very  remarkable  for  their 
womanish  character  and  type  (wide  hips,  form  rounded  by 
abundant  development  of  adipose  tissue,  absence  or  insufficient 
development  of  beard,  feminine  features,  delicate  complexion, 
falsetto  voice,  etc.) ;  and,  on  the  other  hand,  women  that,  by 
reason  of  build,  pelvis,  gait,  attitude,  heavy  and  decidedly 
masculine  features,  rough  and  deep  voice,  etc.,  had  little  to 
remind  one  of  femininity. 

We  have  already  met  some  indications  of  such  an  anthropo- 
logical transformation  in  foregoing  groups,  as  in  Case  106, 
where  the  woman  had  the  feet  of  a  man;  and  in  Case  112, 
where  there  was  development  of  mammae  and  production  of 
milk  during  puberty. 

In  persons  belonging  to  the  fourth  group,  and  in  certain 
ones  in  the  third,  forming  transitions  to  the  fourth,  there  seems 
to  be  a  feeling  of  shame  (sexual)  toward  persons  of  the  same 
sex,  and  not  toward  those  of  the  opposite  sex. 

Case  129.  Androgyny.  Mr.  v.  H.,  aged  30,  single;  of  neuropathic 
mother.  Nervous  and  mental  diseases  are  said  not  to  have  occurred  in 
the  patient's  family,  and  his  only  brother  is  said  to  be  mentally  and 
physically  completely  normal.  The  patient  developed  tardily  physically, 
and,  therefore,  spent  much  of  his  time  at  the  sea-shore  and  climatic 
resorts.  From  childhood  he  was  of  neuropathic  constitution,  and,  accord- 
ing to  the  statements  of  his  relatives,  unlike  other  boys.  His  disinclina- 
tion for  masculine  pursuits  and  his  preference  for  feminine  amusements 
were  early  remarked.  Thus  he  avoided  all  boyish  games  and  gymnastic 
exercises,  while  doll-play  and  feminine  occupations  were  particularly 
pleasing  to  him.  Thereafter  he  developed  well  physically,  and  escaped 
severe  illnesses,  but  he  remained  mentally  abnormal,  incapable  of  an» 
earnest  aim  in  life,  and  decidedly  feminine  in  thought  and  feeling. 

In  his  seventeenth  year  pollutions  occurred,  became  more  frequent, 
and  finally  took  place  during  the  day  ;  so  that  the  patient  grew  weak,  and 

20 


306  PSYCHOPATHIA   SEXUALIS. 

manifested  various  nervous  disturbances.  Symptoms  of  neurasthenia 
spinalis  made  their  appearance,  and  have  lasted  up  to  the  last  few  years, 
but  they  have  become  milder  with  the  decrease  in  the  number  of  pollu- 
tions. Onanism  is  denied,  but  is  very  probable.  An  indolent,  effeminate, 
dreamy  habit  of  thought  has  become  more  and  more  noticeable  ever  since 
puberty.  All  efforts  to  induce  the  patient  to  take  up  an  earnest  pursuit 
in  life  were  vain.  His  intellectual  functions,  though  formally  quite 
undisturbed,  were  never  equal  to  the  motive  of  an  independent  character, 
and  the  higher  ideals  of  life.  He  remained  dependent,  an  overgrown 
child ;  and  nothing  more  clearly  indicated  his  original  abnormal  condi- 
tion than  an  actual  incapability  to  take  care  of  money,  and  his  own  con- 
fession that  he  had  no  ability  to  use  money  reasonably ;  that  as  soon  as 
he  had  money  he  wasted  it  for  curios,  toilet-articles,  and  the  like. 

Incapable  as  he  was  of  a  reasonable  use  of  money,  the  patient  was 
no  more  capable  of  leading  a  social  existence;  indeed,  be  was  incapable 
of  gaining  an  insight  into  its  significance  and  value. 

He  learned  very  poorly,  spending  his  time  in  toilettes  and  artistic 
nothings,  particularly  in  painting,  for  which  he  evinced  a  certain  capa- 
bility; but  in  this  direction  he  accomplished  nothing,  since  he  was 
wanting  in  perseverence.  He  could  not  be  brought  to  take  up  any 
earnest  thought ;  he  had  a  mind  only  for  externals,  was  always  distracted, 
and  serious  things  quickly  wearied  him.  Preposterous  acts,  senseless 
journeys,  waste  of  money,  and  debts  repeatedly  occur  throughout  the 
course  of  his  later  life;  and  even  for  these  positive  faults  in  his  life  he 
was  wanting  in  understanding.  He  was  self-willed  and  intractable,  and 
never  did  well  as  soon  as  an  attempt  was  made  to  put  him  on  his  feet  and 
point  out  to  him  his  own  interests.  V_^> 

With  these  manifestations  of  an  original  abnormal  and  defective 
mind,  there  were  notable  indications  of  perverse  sexual  feeling,  which 
were  also  indicated  in  the  somatic  habitus  of  the  patient.  Sexually,  the 
patient  felt  like  a  woman  toward  men,  and  had  inclinations  toward  people 
of  his  own  sex,  with  indifference,  if  not  actual  disinclination,  for  females. 

In  his  twenty-second  3'ear  it  is  asserted  that  he  had  sexual  inter- 
course with  women,  and  was  able  to  perform  the  act  of  cohabitation  nor- 
mally ;  but,  partly  on  account  of  increase  of  neurasthenic  symptoms 
which  was  occasional  after  coitus,  and  partly  on  account  of  fear  of  infec- 
tion,— but  really  by  reason  of  a  want  of  satisfaction, — he  soon  ceased  to 
indulge  in  such  intercourse.  Concerning  his  abnormal  sexual  condition, 
he  is  not  quite  clear ;  he  is  conscious  of  an  inclination  toward  the  male 
sex,  but  confesses,  only  in  a  shame-faced  way,  that  he  has  certain  pleasur- 
able feelings  of  friendship  for  masculine  individuals,  which,  however,  are 
not  accompanied  b}'  any  sensual  feelings.  The  female  sex  he  does  not 
exactly  abhor ;  he  could  even  bring  himself  to  many  a  woman  who  could 
have  an  attraction  for  him,  by  means  of  similarity  in  artistic  tastes,  if  he 
could  but  be  freed  from  conjugal  duties,  which  were  unpleasant  to  him, 


ANDROGYNY   AND   GYNANDRY.  307 

and  the  performance  of  which  made  him  tired  and  weak.  He  denied 
having  had  sexual  intercourse  with  men,  but  his  blushing  and  embarrass- 
ment, and,  still  more,  an  occurrence  in  N.,  where  the  patient,  some  time 
before,  provoked  a  scandal  by  attempting  to  have  sexual  intercourse  with 
youths,  gave  him  the  lie. 

Too,  his  external  appearance,  habitus,  form,  gestures,  manners,  and 
dress  are  remarkable,  and  decidedly  recall  the  feminine  form  and  charac- 
teristics. The  patient,  howeArer,  is  over  middle  height,  but  thorax  and 
pelvis  are  decidedly  of  feminine  form.  The  body  is  rich  in  fat ;  the  skin  is 
well  cared  for,  delicate,  and  soft.  This  impression  of  a  woman  in  mascu- 
line dress  is  further  increased  by  a  thin  growth  of  hair  on  the  face,  which 
is  shaven,  with  the  exception  of  a  small  moustache ;  by  the  mincing  gait ; 
the  shy,  effeminate  manner;  the  feminine  features;  the  swimming,  neuro- 
pathic expression  of  the  eyes;  the  traces  of  powder  and  paint;  the  cur- 
tailed cut  of  the  clothing,  with  the  bosom-like  prominence  of  the  upper 
garments;  the  fringed,  feminine  cravat;  and  the  hair  brushed  down 
smoothly  from  the  brow  to  the  temples.  The  physical  examination  makes 
undoubted  the  feminine  form  of  the  body.  The  external  genitals  are  well 
developed,  though  the  left  testicle  has  remained  in  the  canal;  the  growth 
of  hair  on  the  mons  veneris  is  thin,  and  the  latter  is  unusually  ricli  in  fat 
and  prominent.     The  voice  is  high,  and  without  masculine  timbre. 

Too,  the  occupation  and  manner  of  thought  of  v.  H.  are  decidedly 
feminine.  He  has  a  boudoir  and  a  well-supplied  toilet-table,  with  which 
he  spends  many  hours  in  all  kinds  of  arts  for  beautifying  himself.  He 
abhors  the  chase,  practice  with  arms,  and  such  masculine  pursuits,  and 
calls  himself  an  aesthete ;  speaks  with  preference  of  his  paintings  and 
attempts  at  poetry.  He  is  interested  in  feminine  occupations,  which — 
e.g.,  embroidery — he  engages  in,  and  calls  his  greatest  pleasure.  He  could 
spend  his  life  in  an  artistic  and  aesthetic  circle  of  ladies  and  gentlemen,  in 
conversation,  music,  and  aesthetics.  His  conversation  is  preferably  about 
feminine  things, — fashions,  needlework,  cooking,  and  household  work. 

The  patient  is  well  nourished,  but  anaemic.  He  is  of  neuropathic 
constitution,  and  presents  symptoms  of  neurasthenia,  which  are  main- 
tained by  a  bad  manner  of  life,  lying  abed,  living  in-doors,  and  effemi- 
nateness.  He  complains  of  occasional  pain  and  pressure  in  the  head,  and 
habitual  obstipation.  He  is  easily  frightened ;  complains  of  occasional 
lassitude  and  fatigue,  and  drawing  pains  in  the  extremities,  in  the  direc- 
tion of  the  lumbo-abdominal  nerves.  After  pollutions,  and  regularly 
after  eating,  he  feels  tired  and  relaxed ;  he  is  sensitive  to  pressure  over 
the  spinous  processes  of  the  dorsal  vertebrae,  as  also  to  pressure  along 
accessible  nerves.  He  feels  peculiar  sympathies  and  antipathies  for  cer- 
tain persons,  and,  when  he  meets  people  for  whom  he  has  an  antipathy, 
he  falls  into  a  condition  of  peculiar  fear  and  confusion.  His  pollutions, 
though  now  they  occur  but  seldom,  are  pathological,  in  that  they  occur 
by  day,  and  are  unaccompanied  by  any  sensual  exciteinent. 


308  PSYCHOPATHIA   SEXUALIS. 

Opinion:  1.  Mr.  v.  H.,  according  to  all  observations  and  reports,  is 
mentally  an  abnormal  and  defective  person,  and  that,  in  fact,  ab  origine. 
His  contrary  sexual  instinct  represents  a  part  of  his  abnormal  physical 
and  mental  condition. 

2.  This  condition,  in  that  it  is  congenital,  is  incurable.  There 
exists  defective  organization  of  the  highest  cerebral  centres,  which  renders 
him  incapable  of  leading  an  independent  life,  and  of  obtaining  a  position 
in  life.  His  perverse  sexual  instinct  prevents  him  from  exercising 
normal  sexual  functions ;  and  this  is  attended  by  all  the  social  conse- 
quences of  such  an  anomaly,  and  the  danger  of  satisfaction  of  perverse 
impulses  arising  out  of  his  abnormal  organization,  with  consequent 
social  and  legal  conflicts.  Fear  of  the  latter,  however,  cannot  be  great, 
since  the  (perverse)  sexual  impulse  of  the  patient  is  weak. 

3.  Mr.  v.  H.,  in  the  legal  sense  of  the  word,  is  not  irresponsible,  and 
neither  fit  for,  or  in  need  of,  treatment  in  a  hospital  for  the  insane.  It  is 
possible  for  him — though  but  an  overgrown  child,  and  incapable  of  per- 
sonal independence — to  live  in  society,  though  under  the  care  and  guid- 
ance of  normal  individuals.  Too,  to  a  certain  extent,  it  is  possible  for 
him  to  respect  the  laws  and  restrictions  of  society,  and  to  judge  his  own 
acts ;  but,  with  respect  of  possible  sexual  errors  and  conflicts  with  crimi- 
nal laws,  it  must  be  emphasized  that  his  sexual  instinct  is  abnormal, 
having  its  origin  in  organic  pathological  conditions ;  and  this  circum- 
stance should  eventually  be  used  in  his  favor.  On  account  of  his  notorious 
lack  of  independence,  he  cannot  be  discharged  from  parental  care  or 
guardianship,  inasmuch  as  otherwise  he  would  be  ruined  financially. 

4.  Mr.  v.  H.  is  also  physically  ill.  He  presents  signs  of  slight 
anaemia  and  of  neurasthenia  spinalis.  A  rational  regulation  of  his  man- 
ner of  life  and  a  tonic  regimen,  and,  if  possible,  hydro-therapeutic  treat- 
ment, seem  necessary.  The  suspicion  that  this  trouble  has  its  origin  in 
early  masturbation  should  be  entertained,  and  the  possibility  of  the 
existence  of  spermatorrhoaa,  that  is  of  importance  etiologically  and  thera- 
peutically, lies  near.     (Personal  case.     Zeitschr.f.  Psychiatrie.) 

Case  130.  Miss  X.,aged  38,  consulted  me,  late  in  the  fall  of  1881,  on 
account  of  severe  spinal  irritation  and  obstinate  sleeplessness,  in  combat- 
ing which  she  had  become  addicted  to  morphine  and  chloral.  Her  mother 
and  sister  were  nervous  sufferers,  but  the  rest  of  the  family  were  healthy. 
The  trouble  dated  from  a  fall  on  her  back  in  1872,  at  which  time  the 
patient  was  terribly  frightened,  though,  when  a  girl,  she  had  been  subject 
to  muscular  cramps  and  hysterical  symptoms.  Following  this  shock, 
a  neurasthenic  and  hysterical  neurosis  developed,  with  predominating 
spinal  irritation  and  sleeplessness.  Episodically,  hysterical  paraplegia, 
lasting  as  long  as  eight  months,  and  hysterical  hallucinatory  delirium, 
with  convulsive  attacks,  occurred.  In  the  course  of  this,  s^ymptoms  of 
morphinism  were  added.  A  stay  of  some  months  in  the  hospital  relieved 
the  latter,  and  considerably  improved  the  neurasthenic  neurosis,  in  the 


ANDROGYNY   AND   GYNANDRY.  309 

treatment  of  which  general  faradization  exerted  a  remarkably  favorable 
influence. 

Even  at  the  first  meeting,  the  patient  produced  a  remarkable  im- 
pression by  reason  of  her  attire,  features,  and  conduct.  She  wore  a 
gentleman's  hat,  her  hair  closely  cut,  eye-glasses,  a  gentleman's  cravat,  a 
coat-like  outer  garment  of  masculine  cut  that  reached  well  down  over  her 
gown,  and  boots  with  high  heels.  She  had  coarse,  somewhat  masculine 
features ;  a  harsh,  deep  voice ;  and  made  rather  the  impression  of  a  man  in 
female  attire  than  that  of  a  lady,  if  one  but  overlooked  the  bosom  and 
the  decidedly  feminine  form  of  the  pelvis.  During  the  long  time  that 
she  was  observed,  there  were  never  signs  of  erotocism.  When  questioned 
concerning  her  attire,  she  would  only  respond  that  the  style  she  chose 
suited  her  better.  Gradually  it  was  ascertained  from  her  that,  even  when 
she  was  a  small  girl,  she  had  had  a  preference  for  horses  and  masculine 
pursuits,  and  never  any  interest  in  feminine  occupations.  Later  she 
developed  a  particular  pleasure  in  reading,  and  prepared  herself  to  be  a 
teacher.  Dancing  had  never  pleased  her ;  it  had  always  seemed  silly  to 
her.  Too,  the  ballet  had  never  interested  her.  Her  greatest  pleasure 
had  always  been  in  the  circus.  Until  her  sickness,  in  1872,  she  had 
neither  had  inclination  for  persons  of  the  opposite  nor  for  those  of  her 
own  sex.  From  that  time  she  had,  what  was  remarkable  to  herself,  a 
peculiar  friendship  for  females,  particularly  for  young  ladies ;  and  she 
had  a  desire,  and  satisfied  it,  to  wear  hats  and  coats  of  masculine  style. 
Since  1869,  besides,  she  had  worn  her  hair  short,  and  parted  it  on  the 
side,  as  men  do.  She  asserts  that  she  was  never  sensually  excited  in  the 
company  of  men,  but  that  her  friendship  and  self-sacrifice  for  sympathetic 
ladies  was  unbounded ;  while  from  that  time  she  also  experienced  repug- 
nance for  gentlemen  and  their  society. 

Her  relatives  report  that,  before  1872,  the  patient  had  a  proposal  of 
marriage,  which  she  refused;  and  that  when  she  returned  from  a  sojourn 
at  a  watering-place,  in  1874,  she  was  sexually  changed,  and  occasionally 
showed  that  she  did  not  regard  herself  as  a  female. 

Since  that  time  she  would  associate  only  with  ladies,  and  has  had  a 
kind  of  love-relation  with  one  or  another,  and  made  remarks  which  indi- 
cated that  she  looked  upon  herself  as  a  man.  This  predilection  for 
women  was  decidedly  more  than  mere  friendship,  since  it  expressed  itself 
in  tears,  jealousy,  etc. 

When,  in  1874,  she  was  stopping  at  a  watering-place,  a  young 
lady,  who  took  her  for  a  man  in  disguise,  fell  in  love  with  her.  When 
this  lady  married,  later,  the  patient  was  for  a  long  time  depressed, 
and  spoke  of  unfaithfulness.  Moreover,  since  her  sickness,  her  relatives 
were  struck  by  her  desire  for  masculine  attire,  her  masculine  conduct,  and 
disinclination  for  feminine  pursuits ;  while  previously,  at  least  sexually, 
she  had  presented  nothing  unusual. 

Further  investigations  showed  that  the  patient  had  a  love-relation, 


310  PSYCHOPATHIA   SEXTJALIS. 

which  was  not  purely  platonic,  with  the  lady  described  in  Case  118  ;  and 
that  she  wrote  her  affectionate  letters  like  those  of  a  lover  to  his  beloved. 
In  1887  I  again  saw  the  patient  in  a  sanitarium,  where  she  had  been 
placed  on  account  of  hystero-epileptic  attacks,  spinal  irritation,  and 
morphinism.  The  contrary  sexual  feeling  existed  unchanged,  and  only 
by  the  most  careful  watching  was  the  patient  kept  from  improper  advances 
toward  her  fellow-patients. 

Her  condition  remained  quite  unchanged  until  1889.  Then  the 
patient  began  to  fail,  and  she  died  of  "exhaustion,"  in  August,  1889. 
The  autopsy  showed,  in  the  vegetative  organs,  amyloid'  degeneration  of 
the  kidneys,  fibroma  of  the  uterus,  and  cyst  of  the  left  ovary.  The  frontal 
bone  was  much  thickened,  uneven  on  the  inner  surface,  with  numerous 
exostoses ;  dura  adherent  to  vault  of  cranium.  Long  diameter  of  skull, 
175  millimetres;  lateral  diameter,  148  millimetres;  weight  of  the  (edema- 
tous, but  not  atrophied,  brain,  1175  grammes.  The  meninges  delicate, 
easily  removed.  Cortex  pale.  Convolutions  broad,  not  numerous, 
regularly  arranged.     Nothing  abnormal  in  cerebellum  and  great  ganglia. 

Case  131.  Gynandry.1  History:  On  November  4,  1889,  the  step- 
father of  a  certain  Count  Sandor  V.  complained  that  the  latter  had 
swindled  him  out  of  800f.,  under  the  pretense  of  requiring  a  bond  as 
secretary  of  a  stock  company.  It  was  ascertained  that  Sandor  had 
entered  into  matrimonial  contracts  and  escaped  from  the  nuptials  in  the 
spring  of  1889 ;  and,  more  than  this,  that  this  ostensible  Count  Sandor 
was  no  man  at  all,  but  a  woman  in  male  attire, — Sarolta  (Charlotte), 
Countess  Y. 

S.  was  arrested,  and,  on  account  of  deception  and  forgery  of  public 
documents,  brought  to  examination.  At  the  first  hearing  S.  confessed 
that  she  was  born  on  Sept.  6,  1866;  that  she  was  a  female,  Catholic, 
single,  and  worked  as  an  authoress  under  the  name  of  Count  Sandor  V. 

From  the  autobiography  of  this  man-woman  I  have  gleaned  the 
following  remarkable  facts  that  have  been  independently  confirmed  : — 

S.  comes  of  an  ancient,  noble,  and  highly-respected  family  of  Hun- 
gary, in  which  there  have  been  eccentricity  and  family  peculiarities.  A 
sister  of  the  maternal  grandmother  was  hysterical,  a  somnambulist,  and 
lay  seventeen  years  in  bed,  on  account  of  fancied  paralysis.  A  second 
great-aunt  spent  seven  years  in  bed,  on  account  of  a  fancied  fatal  illness, 
and  at  the  same  time  gave  balls.  A  third  had  the  whim  that  a  certain 
table  in  her  salon  was  bewitched.  If  anything  were  laid  on  this  table,  she 
would  become  greatly  excited  and  cry,  "  Bewitched !  bewitched  !"  and  run 
with  the  object  into  a  room  which  she  called  the  "  Black  Chamber,"  and 
the  key  of  which  she  never  let  out  of  her  hands.  After  the  death  of  this 
lady,  there  were  found  in  this  chamber  a  number  of  shawls,  ornaments, 

1  Comp.  the  expert  medical  opinion  of  this  case,  by  Dr.  Birnbacher,  in  Friedreich's 
Blatter  f.  ger.  Med.,  1891,  H.  1. 


ANDROGYNY   AND   GYNANDRY.  311 

bank-notes,  etc.  A  .fourth  great-aunt,  during  two  years,  did  not  leave 
her  room,  and  neither  washed  herself  nor  combed  her  hair;  then  she 
again  made  her  appearance.  All  these  ladies  were,  nevertheless,  intel- 
lectual, finely  educated,  and  amiable. 

S.'s  mother  was  nervous,  and  could  not  bear  the  light  of  the  moon. 

From  her  father's  family  it  is  said  she  had  a  trace  too  much.  One 
line  of  the  family  gave  itself  up  almost  entirely  to  spiritualism.  Two 
blood-relations  on  the  father's  side  shot  themselves.  The  majority  of  her 
male  relatives  are  unusually  talented  ;  the  females  are  decidedly  narrow 
and  domestic.  S.'s  father  had  a  high  position,  which,  however,  on  account 
of  his  eccentricity  and  extravagance  (he  wasted  over  a  million  and  a  half), 
he  lost. 

Among  many  foolish  things  that  her  father  encouraged  in  her  was 
the  fact  that  he  brought  her  up  as  a  boy,  called  her  Sandor,  allowed  her 
to  ride,  drive,  and  hunt,  admiring  her  muscular  energy. 

On  the  other  hand,  this  foolish  father  allowed  his  second  son  to  go 
about  in  female  attire,  and  had  him  brought  up  as  a  girl.  This  farce 
ceased  in  his  fifteenth  year,  when  the  son  was  sent  to  a  higher  school. 

Sarolta-Sandor  remained  under  her  father's  influence  till  her  twelfth 
year,  and  then  came  under  the  care  of  her  eccentric  maternal  grand- 
mother, in  Dresden,  by  whom,  when  the  masculine  play  became  too  ob- 
vious, she  was  placed  in  an  Institute,  and  made  to  wear  female  attire. 

At  thirteen  she  had  a  love-relation  with  an  English  girl,  to  whom 
she  represented  herself  as  a  boy,  and  ran  away  with  her. 

Sarolta  returned  to  her  mother,  who,  however,  could  do  nothing,  and 
was  compelled  to  allow  her  daughter  to  again  become  Sandor,  wear  male 
clothes,  and,  at  least  once  a  year,  to  fall  in  love  with  persons  of  her  own 
sex. 

At  the  same  time,  S.  received  a  careful  education,  and  made  long 
journeys  with  her  father, — of  course,  always  as  a  young  gentleman.  She 
early  became  independent,  and  visited  cafes,  even  those  of  doubtful  char- 
acter, and,  indeed,  boasted  one  day  that  in  a  brothel  she  had  had  a  girl 
sitting  on  each  knee.  S.  was  often  intoxicated,  had  a  passion  for  mascu- 
line sports,  and  was  a  very  skillful  fencer. 

She  felt  herself  drawn  particularly  toward  actresses,  or  others  of 
similar  position,  and,  if  possible,  toward  those  who  were  not  very  young. 
She  asserts  that  she  never  had  any  inclination  for  a  young  man,  and  that 
she  has  felt,  from  year  to  year,  an  increasing  dislike  for  young  men. 

"  I  preferred  to  go  into  the  society  of  ladies  with  ugly,  ill-favored 
men,  so  that  none  of  them  could  put  me  in  the  shade.  If  I  noticed  that 
any  of  the  men  awakened  the  sympathies  of  the  ladies,  I  felt  jealous.  I 
preferred  ladies  who  were  bright  and  pretty ;  I  could  not  endure  them 
if  they  were  fat  or  much  inclined  toward  men.  It  delighted  me  if  the 
passion  of  a  lady  was  disclosed  under  a  poetic  veil.  All  immodesty  in  a 
woman  was  disgusting  to  me.     I  had  an  indescribable  aversion  for  female 


312  PSYCHOPAtHIA   SEXUALIS. 

attire, — indeed,  for  everything  feminine, — but  only  in  as  far  as  it  con- 
cerned me ;  for,  on  the  other  hand,  I  was  all  enthusiasm  for  the  beau- 
tiful sex." 

During  the  last  ten  years  S.  had  lived  almost  constantly  away  from 
her  relatives,  in  the  guise  of  a  man.  She  had  had  many  liaisons  with 
ladies,  traveled  much,  spent  much,  and  made  debts. 

At  the  same  time,  she  carried  on  literary  work,  and  was  a  valued 
collaborator  on  two  noted  journals  of  the  Capital. 

Her  passion  for  ladies  was  very  changeable ;  constancy  in  love  was 
entirely  wanting. 

Only  once  did  such  a  liaison  last  three  years.  It  was  years  before 
that  S.,  at  Castle  Gr.,  made  the  acquaintance  of  Emma  E.,  who  was  ten 
years  older  than  herself.  She  fell  in  love  with  her,  made  a  marriage- 
contract  with  her,  and  they  lived  together,  as  man  and  wife,  for  three 
years  at  the  Capital. 

A  new  love,  which  S.  regarded  as  a  fate,  caused  her  to  sever  her 
matrimonial  relations  with  E.  The  latter  would  not  have  it  so.  Only 
with  the  greatest  sacrifice  was  S.  able  to  purchase  her  freedom  from  E., 
who,  it  is  reported,  still  looks  upon  herself  as  a  divorced  wife,  and  regards 
herself  as  the  Countess  V.  1  That  S.  also  had  the  power  to  excite 
passion  in  other  women  is  shown  bjr  the  fact  that  when  she  (before  her 
marriage  with  E.)  had  grown  tired  of  a  Miss  D.,  after  having  spent 
thousands  of  guldens  on  her,  she  was  threatened  with  shooting  by  D.  if 
she  should  become  untrue. 

It  was  in  the  summer  of  1887,  while  at  a  watering-place,  that  S. 
made  the  acquaintance  of  a  distinguished  official's  family.  Immediately 
she  fell  in  love  with  the  daughter,  Marie,  and  her  love  was  returned. 

Her  mother  and  cousin  tried  in  vain  to  break  up  this  affair.  During 
the  winter,  the  lovers  corresponded  zealously.  In  April,  1888,  Count  S. 
paid  her  a  visit,  and  in  Ma}r,  1889,  attained  her  wish;  in  that  Marie — 
who,  in  the  meantime,  had  given  up  a  position  as  teacher — became  her 
bride  in  the  presence  of  a  friend  of  her  lover,  the  ceremony  being  per- 
formed in  an  arbor,  by  a  false  priest,  in  Hungary.  S.,  with  her  friend, 
forged  the  marriage-certificate.  The  pair  lived  happily,  and,  without  the 
interference  of  the  step-father,  this  false  marriage,  probably,  would  have 
lasted  much  longer.  It  is  remarkable  that,  during  the  comparatively 
long  existence  of  the  relation,  S.  was  able  to  deceive  completely  the 
family  of  her  bride  with  regard  to  her  true  sex. 

S.  was  a  passionate  smoker,  and  in  all  respects  her  tastes  and  pas- 
sions were  masculine.  Her  letters  and  even  legal  documents  reached  her 
under  the  address  of  "  Count  S."  She  often  spoke  of  having  to  drill. 
From  remarks  of  the  father-in-law,  it  seems  that  S.  (and  she  afterward 
confessed  it)  knew  how  to  imitate  a  scrotum  with  handkerchiefs  or  gloves 
stuffed  in  the  trousers.  The  father-in-law  also,  on  one  occasion,  noticed 
something  like  an  erected  member  on  his  future  son-in-law  (probably  a 


ANDROGYNY   AND   GYNANDRY.  313 

priapus).  She  also  occasionally  remarked  that  she  was  obliged  to  wear  a 
suspensory  bandage  while  riding.  The  fact  is,  S.  wore  a  bandage  around 
the  body,  possibly  as  a  means  of  retaining  a  priapus. 

Though  S.  often  had  herself  shaved  pro  forma,  the  servants  in  the 
hotel  where  she  lived  were  convinced  that  she  was  a  woman,  because  the 
chambermaids  found  traces  of  menstrual  blood  on  her  linen  (which  S. 
explained,  however,  as  hemorrhoidal) ;  and,  on  the  occasion  of  a  bath 
which  S.  was  accustomed  to  take,  they  claimed  to  have  convinced  them- 
selves of  her  real  sex  by  looking  through  the  key -hole. 

The  family  of  Marie  make  it  seem  probable  that  she  for  a  long  time 
was  deceived  with  regard  to  the  true  sex  of  her  false  bridegroom.  The 
following  passage  in  a  letter  from  Marie  to  S.,  August  26,  1889,  speaks 
in  favor  of  the  incredible  simplicity  and  innocence  of  this  unfortunate 
girl :  "  I  don't  like  children  any  more,  but  if  I  had  a  little  Bezerl  or 
Patscherl  by  my  Sandi, — ah,  what  happiness,  Sandi  mine !  " 

A  large  number  of  manuscripts  allow  conclusions  to  be  drawn 
concerning  S.'s  mental  individuality.  The  chirography  possesses  the 
character  of  firmness  and  certainty.  The  characters  are  genuinely  mas- 
culine. The  same  peculiarities  repeat  themselves  everywhere  in  their 
contents, — wild,  unbridled  passion  ;  hatred  and  resistance  to  all  that 
opposes  the  heart  thirsting  for  love ;  poetical  love,  which  is  not  marred 
hy  one  ignoble  blot ;  enthusiasm  for  the  beautiful  and  noble ;  appreciation 
of  science  and  the  arts. 

Her  writings  betray  a  wonderfully  wide  range  of  reading  in  classics 
of  all  languages,  in  citations  from  poets  and  prose  writers  of  all  lands. 
The  evidence  of  those  qualified  to  judge  literary  work  shows  that  S.'s 
poetical  and  literary  ability  is  by  no  means  small.  The  letters  and 
writings  concerning  the  relation  with  Marie  are  psychologically  worthy 
of  notice. 

S.  speaks  of  the  happiness  there  was  for  her  when  by  M.'s  side, 
and  expresses  boundless  longing  to  see  her  beloved,  if  only  for  a  moment. 
After  such  a  happiness,  she  could  have  but  one  wish, — to  exchange  her 
cell  for  the  grave.  The  bitterest  thing  was  the  knowledge  that  now 
Marie,  too,  hated  her.  Hot  tears,  enough  to  drown  herself  in,  she  had 
shed  over  her  lost  happiness.  Whole  quires  of  paper  are  given  up  to 
the  apotheosis  of  this  love,  and  reminiscences  of  the  time  of  the  first 
love  and  acquaintance. 

S.  complained  of  her  heart,  that  would  allow  no  reason  to  direct  it ; 
she  expressed  emotions  which  were  such  as  only  could  be  felt, — not  sim- 
ulated. Then,  again,  there  were  outbreaks  of  most  silly  passion,  with 
the  declaration  that  she  could  not  live  without  Marie.  "  Thy  dear,  sweet 
voice ;  the  voice  whose  tone  perchance  would  raise  me  from  the  dead ; 
that  has  been  for  me  like  the  warm  breath  of  Paradise!  Thy  presence 
alone  were  enough  to  alleviate  my  mental  and  moral  anguish.  It  was  a 
magnetic  stream ;  it  was  a  peculiar  power  your  being  exercised  over 


314  PSYCHOPATH! A   SEXUALIS. 

mine,  which  I  cannot  quite  define ;  and,  therefore,  I  cling  to  that  ever- 
true  definition :  I  love  you  because  I  love  you.  In  the  night  of  sorrow 
I  had  but  one  star, — the  star  of  Marie's  love.  That  star  has  lost  its 
light ;  now  there  remains  but  its  shimmer, — the  sweet,  sad  memory 
which  even  lights  with  its  soft  ray  the  deepening  night  of  death, — a  ray 
of  hope." 

This  writing  ends  with  the  apostrophe :  "  Gentlemen,  you  learned  in 
the  law,  psychologists  and  pathologists,  do  me  justice !  Love  led  me  to 
take  the  step  I  took ;  all  my  deeds  were  conditioned  by  it.  God  put  it 
in  my  heart. 

"  If  He  created  me  so,  and  not  otherwise,  am  I  then  guilty  ;  or  is  it 
the  eternal,  incomprehensible  way  of  fate  ?  I  relied  on  God,  that  one  day 
my  emancipation  would  come;  for  my  thought  was  only  love  itself, 
which  is  the  foundation,  the  guiding  principle,  of  His  teaching  and  His 
kingdom. 

"O  God,  Thou  All-pitying,  Almighty  Onel  Thou  seest  my  dis- 
tress ;  Thou  knowest  how  I  suffer.  Incline  Thyself  to  me ;  extend  Thy 
helping  hand  to  me,  deserted  by  all  the  world.  Only  God  is  just.  How 
beautifully  does  Victor  Hugo  describe  this  in  his  '  Legendes  du  Siecle ' ! 
How  sad  do  Mendelssohn's  words  sound  to  me :  '  Nightly  in  dreams  I 
see  thee'!" 

Though  S.  knew  that  none  of  her  writings  reached  her  lover,  she 
did  not  grow  tired  writing  of  her  pain  and  delight  in  love,  in  page  after 
page  of  deification  of  Marie.  And  to  induce  one  more  pure  flood  of 
tears,  on  one  still,  clear  summer  evening,  when  the  lake  was  aglow  with 
the  setting  sun  like  molten  gold,  and  the  bells  of  St.  Anna  and  Maria- 
Worth,-  blending  in  harmonious  melancholy,  gave  tidings  of  rest  and 
peace,  she  wrote :  "  For  that  poor  soul,  for  this  poor  heart  that  beat 
for  thee  till  the  last  breath^ 

Personal  Examination:  The  first  meeting  which  the  experts  had 
with  S.  was,  in  a  measure,  a  time  of  embarrassment  to  both  sides ;  for 
them,  because  perhaps  S.'s  somewhat  dazzling  and  forced  masculine  car- 
riage impressed  them ;  for  her,  because  she  thought  she  was  to  be  marked 
with  the  stigma  of  moral  insanity.  She  had  a  pleasant  and  intelligent 
face,  which,  in  spite  of  a  certain  delicacy  of  features  and  diminutive- 
ness  of  all  its  parts,  gave  a  decidedly  masculine  impression,  had  it  not 
been  for  the  absence  of  a  moustache.  It  was  even  difficult  for  the  experts 
to  realize  that  they  were  concerned  with  a  woman,  despite  the  fact  of 
female  attire  and  constant  association  ;  while,  on  the  other  hand,  inter- 
course with  the  man  Sandor  was  much  more  free,  natural,  and  apparently 
correct.  The  culprit  also  felt  this.  She  immediately  became  more  open, 
more  communicative,  more  free,  as  soon  as  she  was  treated  like  a  man. 

In  spite  of  her  inclination  for  the  female  sex,  which  had  been 
present  from  her  earliest  years,  she  asserts  that  in  her  thirteenth  year 
she  first  felt  a  trace  of  sexual  feeling,  which  expressed  itself  in  kisses, 


ANDROGYNY  AND  GYNANDRY.  315 

embraces,  and  caresses,  with  sensual  pleasure,  and  this  on  the  occasion 
of  her  elopement  with  the  red-haired  English  girl  from  the  Dresden 
Institute.  At  that  time  feminine  forms  exclusively  appeared  to  her  in 
dream-pictures,  and  ever  since,  in  sensual  dreams,  she  has  felt  herself  in 
the  situation  of  a  man,  and  occasionally,  also,  at  such  times,  experienced 
ejaculation. 

She  knows  nothing  of  solitary  or  mutual  onanism.  Such  a  thing 
seemed  very  disgusting  to  her,  and  not  conducive  to  manliness.  She 
had,  also,  never  allowed  herself  to  be  touched  ad  genitalia  by  others, 
because  it  would  have  revealed  her  great  secret.  The  menses  began  at 
seventeen,  but  were  always  scanty,  and  without  pain.  It  was  plain  to 
be  seen  that  S.  had  a  horrpr  of  speaking  of  menstruation  ;  that  it  was  a 
thing  repugnant  to  her  masculine  consciousness  and  feeling.  She  recog- 
nized the  abnormality  of  her  sexual  inclinations,  but  had  no  desire  to 
have  them  changed,  since  in  this  perverse  feeling  she  felt  both  well  and 
happy.  The  idea  of  sexual  intercourse  with  men  disgusted  her,  and  she 
also  thought  it  would  be  impossible. 

Her  modesty  was  so  great  that  she  would  prefer  to  sleep  among 
men  rather  than  among  women.  Thus,  when  it  was  necessary  for  her  to 
answer  the  calls  of  nature  or  to  change  her  linen,  it  was  necessary  for  her 
to  ask  her  companion  in  the  cell  to  turn  her  face  to  the  window,  that  she 
might  not  see  her. 

When  occasionally  S.  came  in  contact  with  this  companion, — a 
woman  from  the  lower  walks  of  life, — she  experienced  a  sexual  excite- 
ment that  made  her  blush.  Indeed,  without  being  asked,  S.  related  that 
she  was  overcome  with  actual  fear  when,  in  her  cell,  she  was  compelled 
to  force  herself  into  the  unusual  female  attire.  Her  only  comfort 
was,  that  she  was  at  least  allowed  to  keep  a  shirt.  Remarkable,  and 
what  also  speaks  for  the  significance  of  olfactory  sensations  in  her  vita 
sexualis,  is  her  statement  that,  on  the  occasions  of  Marie's  absence,  she 
had  sought  those  places  on  which  Marie's  head  was  accustomed  to 
repose,  and  smelled  of  them,  in  order  to  experience  the  delight  of  inhal- 
ing the  odor  of  her  hair.  Among  women,  those  who  are  beautiful,  or 
voluptuous,  or  quite  young  do  not  particularly  interest  her.  The  physical 
charms  of  women  she  makes  subordinate.  As  by  magnetic  attraction, 
she  feels  herself  drawn  to  those  between  twenty-four  and  thirty.  She 
found  her  sexual  satisfaction  exclusivel}-  in  corpora  feminse  (never  in 
her  own  person),  in  the  form  of  manustupration  of  the  beloved  woman, 
or  cunnilingus.  Occasionally  she  availed  herself  of  a  stocking  stuffed 
with  oakum  as  a  priapus.  These  admissions  were  made  only  unwillingly 
by  S.,  and  with  apparent  shame;  just  as  in  her  writings,  immodest}*  or 
cynicism  are  never  found. 

She  is  religious,  has  a  lively  interest  in  all  that  is  noble  and  beau- 
tiful,— men  excepted, — and  is  very  sensitive  to  the  opinion  others  may 
entertain  of  her  morality. 


316  PSYOHOPATHIA   SEXUALIS. 

She  deepty  regrets  that  in  her  passion  she  made  Marie  unhappy, 
and  regards  her  sexual  feelings  as  perverse,  and  such  a  love  of  one  woman 
for  another,  among  normal  individuals,  as  morally  reprehensible.  She 
has  great  literary  talent  and  an  extraordinary  memory.  Her  only  weak- 
ness is  her  great  frivolity  and  her  incapability  to  manage  money  and 
property  reasonably.  But  she  is  conscious  of  this  weakness,  and  does 
not  care  to  talk  about  it. 

She  is  153  centimetres  tall,  of  delicate  skeleton,  thin,  but  remark- 
ably muscular  on  the  breast  and  thighs.  Her  gait  in  female  attire  is 
awkward.  Her  movements  are  powerful,  not  un pleasing,  though  they 
are  somewhat  masculine,  and  lacking  in  grace.  She  greets  one  with  a 
firm  pressure  of  the  hand.  Her  whole  carriage  is  decided,  firm,  and 
somewhat  self-conscious.  Her  glance  is  intelligent;  mien  somewhat 
diffident.  Feet  and  hands  remarkably  small,  having  remained  in  an 
infantile  stage  of  development.  Extensor  surfaces  of  the  extremities 
remarkably  well  covered  with  hair,  while  there  is  not  the  slightest  trace 
of  beard,  in  spite  of  all  shaving  experiments.  The  hips  do  not  corre- 
spond in  any  way  with  those  of  a  female.  Waist  is  wanting.  The  pelvis 
is  so  slim,  and  so  little  prominent,  that  a  line  drawn  from  the  axilla  to 
the  corresponding  knee  is  straight, — not  curved  inward  by  a  waist,  or 
outward  bj^  the  pelvis.  The  skull  is  slightly  oxycephalic,  and  in  all  its 
measurements  falls  below  the  average  of  the  female  skull  by  at  least  one 
centimetre. 

The  circumference  of  the  head  is  52  centimetres ;  the  occipital  half- 
circumference,  24  centimetres  ;  the  line  from  ear  to  ear,  over  the  vertex, 
23  centimetres ;  the  anterior  half-circumference,  28.5  centimetres ;  the 
line  from  glabella  to  occiput,  30  centimetres ;  the  ear-chin  line,  26.5 
centimetres;  long  diameter,  1Y  centimetres;  greatest  lateral  diameter, 
13  centimetres;  diameter  at  auditory  meati,  12  centimetres;  zj^gomatic 
diameter,  11.2  centimetres.  The  upper  jaw  projects  strikingly,  its  alveolar 
process  projecting  beyond  the  under  jaw  about  0.5  centimetre.  The 
position  of  the  teeth  is  not  fully  normal ;  the  right  upper  canine  has  not 
developed.  Mouth  remarkably  small.  Ears  prominent ;  lobes  not  differ- 
entiated, passing  over  into  the  skin  of  the  cheek.  Hard  palate  narrow 
and  high ;  voice  rough  and  deep;  mammae  fairly  developed,  soft,  and 
without  secretion.  Mons  veneris  covered  with  thick,  dark  hair.  Gen- 
itals completely  feminine,  without  trace  of  hermaphroditic  appearance, 
but  at  the  stage  of  development  of  those  of  a  ten-year-old  girl.  The  labia 
m:\jora  touch  each  other  almost  completely  ;  labia  minora  have  a  cock's- 
comb-like  form,  and  project  under  the  labia  majora.  The  clitoris  is  small, 
and  very  sensitive.  Frenulum  delicate  ;  perineum  very  narrow  ;  introitus 
vaginas  narrow ;  mucous  membrane  normal.  Hj'men  wanting  (probably 
congenitally)  ;  likewise,  the  carunculre  myrtiformes.  Yagina  so  narrow 
that  the  insertion  of  a  membrum  virile  would  be  impossible,  and  it  is  also 
very  sensitive;  certainly  coitus  had  not  taken  place.      Uterus  is  felt, 


ANDROGYNY   AND   GYNANDRY.  317 

through  the  rectum,  to  be  about  the  size  of  a  walnut,  immovable,  and 
retroflected. 

The  pelvis  appears  generally  narrowed  (dwarf-pelvis),  and  of  decid- 
edly masculine  type.  The  distance  between  anterior  superior  spines  is 
22.5  centimetres  (instead  of  26.3  centimetres).  Distance  between  the 
crests  of  the  ilii,  26.5  centimetres  (instead  of  29.3  centimetres)  ;  between 
the  trochanters,  27.7  centimetres  (31);  the  external  conjugate  diameter, 
17.2  centimetres  (19  to  20) ;  therefore,  presumably,  the  internal  conju- 
gate would  be  7.7  centimetres  (10.8).  On  account  of  narrowness  of  the 
pelvis,  the  direction  of  the  thighs  is  not  convergent,  as  in  a  woman,  but 
straight. 

The  opinion  given  showed  that  in  S.  there  was  a  congenitally 
abnormal  inversion  of  the  sexual  instinct,  which,  indeed,  expressed 
itself,  anthropologically,  in  anomalies  of  development  of  the  body, 
depending  upon  great  hereditary  taint ;  further,  that  the  criminal  acts 
of  S.  had  their  foundation  in  her  abnormal  and  irresistible  sexuality. 

S.'s  characteristic  expressions — "  God  put  love  in  my  heart.  If  lie 
created  me  so,  and  not  otherwise,  am  I,  then,  guilty ;  or  is  it  the  eternal, 
incomprehensible  way  of  fate?" — are  really  justified. 

The  court  granted  pardon.  The  "  countess  in  male  attire,"  as  she 
was  called  in  the  newspapers,  returned  to  her  home,  and  again  gave  her- 
self out  as  Count  Sandor.  Her  only  distress  is  her  lost  happiness  with 
her  beloved  Marie. 

A  married  woman,  in  Brandon,  Wisconsin,  whose  case  is  reported 
by  Dr.  Kiernan  (  The  Medical  Standard,  1888,  November  and  December), 
was  more  fortunate.  She  eloped,  in  1883,  with  a  young  girl,  married  her, 
and  lived  with  her  as  husband  undisturbed. 

An  interesting  "  historical "  example  of  androgyny  is  a  case  reported 
by  Spitzka  (Chicago  Medical  Review,  August  20,  1881).  It  was  that  of 
Lord  Cornbury,  Governor  of  New  York,  who  lived  in  the  reign  of  Queen 
Anne.  He  was  apparently  affected  with  moral  insanity ;  was  terribly 
licentious,  and,  in  spite  of  his  high  position,  could  not  keep  himself  from 
going  about  in  the  streets  in  female  attire,  coquetting  with  all  the  allure- 
ments of  a  prostitute. 

In  a  picture  of  him  that  has  been  preserved,  his  narrow  brow, 
asymmetrical  face,  feminine  features,  and  sensual  mouth  at  once  attract 
attention.  It  is  certain  that  he  never  actually  regarded 'himself  as  a 
woman. 


Moreover,  in  individuals  afflicted  with  contrary  sexual 
instinct,  in  themselves,  the  perverse  sexual  feeling  and  inclina- 
tion may  be  complicated  with  other*  perverse  manifestations. 
Thus  here,  with  reference  to  the  activity  of  the  instinct,  there 


318  PSYCHOPATHIA   SEXUALIS. 

may  be  acts  quite  analogous  to  acts  indulged  in  by  individuals 
in  perverse  satisfaction  of  the  instinct,  but  who,  at  the  same 
time,  have  a  natural  inclination  toward  persons  of  the  opposite 
sex. 

Owing  to  the  circumstance  that  abnormally  increased  sex- 
uality is  almost  a  regular  accompaniment  of  contrary  sexual 
feeling,  acts  of  lustful  cruelty  in  the  satisfaction  of  libido  are 
easily  possible.  A  remarkable  example  of  this  is  the  case  of 
Zastrow  (Casper-Liman,  7.  Aufiage,  Bd.  i,  p.  190;  ii,  p.  487), 
who  bit  one  of  his  victims  (a  boy),  tore  his  prepuce,  slit  the  anus, 
and  strangled  the  child. 

Z.  came  of  a  psychopathic  grandfather  and  melancholic  mother. 
His  brother  indulged  in  abnormal  sexual  pleasures,  and  committed 
suicide. 

Z.  was  a  congenital  urning,  and  in  habitus  and  occupation  mascu- 
line. There  was  phimosis.  Mentally,  he  was  a  weak,  perverse,  unsocial 
man.  He  had  horror  feminae,  and,  in  his  dreams,  he  felt  himself  like  a 
woman  toward  a  man.  He  was  painfully  conscious  of  his  want  of  normal 
sexual  feeling  and  his  perverse  instinct,  and  sought  satisfaction  in  mutual 
onanism,  with  frequent  desire  for  pederasty. 

Similar  sadistic  feelings  of  this  kind,  in  those  afflicted  with 
contrary  sexual  instinct,  are  found  in  some  of  the  foregoing  his- 
tories (comp.  Cases  107  and  108  of  this  edition,  and  Case  96  of 
the  sixth  edition).  But  masochism  also  occurs  (comp.  Case  43, 
sixth  edition ;  Cases  111  and  114  of  this  edition;  and  Case  3,  in 
the  first  edition  of  "  Neue  Forschungen  "). 

As  examples  of  perverse  sexual  satisfaction  dependent  on  contrary 
sexual  instinct,  may  be  mentioned  the  Greek,  who,  as  Athenaus  reports, 
was  in  love  with  a  statue  of  Cupid,  and  defiled  it,  in  the  temple  of  Delphi ; 
and"  besides  the  monstrous  cases  reported  by  Tardieu  ("Attentats,"  p. 
272),  the  terrible  one  reported  by  Lombroso  ("  L'uomo  delinquente,"  p. 
200),  of  a  certain  Artusio,  who  wounded  a  boy  in  the  abdomen,  and  abused 
him  sexually  by  means  of  the  incisions. 

Cases  86,  110,  and  111,  also,  show  that  fetichism  may  also  occur 
with  contrary  sexual  instinct. 


DIAGNOSIS   AND   PROGNOSIS.  319 


DIAGNOSIS,  PROGNOSIS,  AND  THERAPY  OF  CONTRARY 
SEXUAL  INSTINCT. 

While  up  to  this  time  contrary  sexual  instinct  has  had  but 
an  anthropological,  clinical,  and  forensic  interest  for  science, 
now,  as  a  result  of  the  latest  investigations,  there  is  some 
thought  of  therapy  in  this  incurable  condition,  which  so  heavily 
burdens  its  victims,  socially,  morally,  and  mentally. 

A  preparatory  step  for  the  application  of  therapeutic  meas- 
ures is  the  exact  differentiation  of  the  acquired  from  the  con- 
genital cases ;  and  among  the  latter,  again,  the  assignment  of 
the  concrete  case  to  its  proper  position  in  the  categories  that 
have  been  established  empirically. 

The  diagnostic  differentiation  of  the  acquired  from  the 
congenital  condition  is  made  without  difficulty  in  the  early  stages 
of  the  anomaly. 

If  sexual  inversion  has  already  taken  place,  then  the  history 
of  the  development  of  the  case  will  throw  light  upon  it. 

The  important  decision,  prognostically,  as  to  whether  the 
contrary  sexual  instinct  is  congenital  or  acquired,  can  only  be 
made  in  such  cases  by  means  of  the  most  minute  details  of  the 
history. 

The  establishment  of  the  fact  that  contrary  sexual  instinct 
existed  before  indulgence  in  masturbation  is  of  great  importance 
with  reference  to  deciding  whether  the  anomaly  is  congenital  or 
not.  In  this,  however,  a  difficulty  arises,  owing  to  the  possibility 
of  imperfect  localization  of  past  events  (illusions  of  memory). 

For  the  presumption  of  acquired  contrary  sexual  instinct, 
it  is  important  to  prove  the  existence  of  hetero-sexual  instinct 
before  the  beginning  of  solitary  or  mutual  onanism. 

In  general,  the  acquired  cases  are  characterized  in  that : — 

1.  The  homo-sexual  instinct  appears  secondarily,  and 
always  may  be  referred  to  influences  (masturbatic  neurasthe- 
nia, mental)  which  disturbed  normal  sexual  satisfaction.  It  is, 
however,  probable  that  here,  in  spite  of  powerful  sensual  libido, 
the  feeling  and  inclination  for  the  opposite  sex  are  weak  ah 
origine,  especially  in  a  spiritual  and  aesthetic  sense, 


320  PSYCHOPATHIA   SEXUALIS. 

2.  The  homo-sexual  instinct,  as  long  as  inversio  sexualis 
has  not  taken  place,  is  looked  upon,  by  the  individual  affected, 
as  vicious  and  abnormal,  and  yielded  to  o\Aj  faute  de  mieux. 

3.  The  hetero-sexual  instinct  long  remains  predominant, 
and  the  impossibility  of  its  satisfaction  gives  pain.  It  weakens 
in  proportion  as  the  homo-sexual  feeling  gains  in  strength. 

On  the  other  hand,  in  congenital  cases  (a)  the  homo-sexual 
instinct  is  the  one  that  occurs  primarily,  and  becomes  dominant 
in  the  vita  sexualis.  It  appears  as  the  natural  manner  of  satis- 
faction, and  also  dominates  the  dream-life  of  the  individual. 
(b)  The  hetero-sexual  instinct  fails  completely,  or,  if  it  should 
make  its  appearance  during  the  life  of  the  individual  (psycho- 
sexual  hermaphroditism),  it  is  still  but  an  episodical  phenomenon 
'which  has  no  root  in  the  mental  constitution  of  the  individual, 
and  is  essentially  but  a  means  of  satisfaction  of  sexual  desire. 

The  differentiation  of  the  above  groups  of  congenital  con- 
trary sexuality  from  one  another,  and  from  the  cases  in  which 
the  anomaly  is  acquired,  will,  after  the  foregoing,  present  no 
difficulties. 

The  prognosis  of  the  cases  of  acquired  contrary  sexual 
instinct  is,  at  all  events,  much  more  favorable  than  that  of  the 
congenital  cases.  In  the  former,  the  occurrence  of  effemination 
— the  mental  inversion  of  the  individual,  in  the  sense  of  per- 
verse sexual  feeling — is  the  limit  beyond  which  there  is  no 
longer  hope  of  benefit  from  therapy.  In  the  congenital  cases, 
the  various  categories  established  in  this  book  form  as  many 
stages  of  psycho-sexual  taint,  and  benefit  is  probable  only 
within  the  category  of  the  psychical  hermaphrodites,  though 
possible  (vide  the  case  of  Schrenk-Notzing)  in  that  of  the  timings. 

The  prophylaxis  of  these  conditions  becomes  thus  the 
more  important, — for  the  congenital  cases,  prohibition  of  the 
reproduction  of  such  unfortunates ;  for  the  acquired  cases,  pro- 
tection from  the  injurious  influences  which  experience  teaches 
may  lead  to  the  fatal  inversion  of  the  sexual  instinct. 

Numerous  predisposed  individuals  meet  this  sad  fate,  be- 
cause parents  and  teachers  have  no  suspicion  of  the  danger 
which  masturbation  brings  in  its  train  to  such  children. 


THERAPY.  321 

In  many  schools  and  academies  masturbation  and  vice  are 
actually  cultivated.  At  present  much  too  little  attention  is 
given  to  the  mental  and  moral  peculiarities  of  the  pupils.  If 
only  the  tasks  are  done,  nothing  more  is  asked.  That  many 
pupils  are  thus  ruined  in  body  and  soul  is  never  considered. 
In  obedience  to  affected  prudery,  the  vita  sexualis  is  veiled 
from  the  developing  youth,  and  not  the  slightest  attention  given 
to  the  excitations  of  his  sexual  instinct.  How  few  family 
physicians  are  ever  called  in,  during  the  years  of  development 
of  children,  to  give  advice  to  their  patients  that  are  often  so 
greatly  predisposed ! 

It  is  thought  that  all  must  be  left  to  Nature ;  in  the  mean- 
time, Nature  rises  in  her  power,  and  leads  the  helpless,  unpro- 
tected innocent  into  dangerous  by-paths. 

A  more  detailed  treatment  of  this  prophylactic  side  of  the 
subject  is  impossible  here.1 

To  parents  and  teachers,  the  experiences  detailed  in  this 
work,  and  numerous  scientific  works  on  masturbation,  give 
suggestions. 

The  lines  of  treatment,  when  contrary  sexual  instinct  ex- 
ists, are  the  following : — 

1.  Prevention  of  onanism,  and  removal  of  other  influences 
injurious  to  the  vita  sexualis. 

2.  Cure  of  the  neurosis  (neurasthenia  sexualis  and  univer- 
salis) arising  out  of  the  unhygienic  conditions  of  the  vita 
sexualis. 

3.  Mental  treatment,  in  the  sense  of  combating  homo- 
sexual, and  encouraging  hetero-sexual,  feelings  and  impulses. 

The  most  important  part  of  the  treatment  lies  in  fulfilling 
the  third  indication,  particularly  with  reference  to  onanism. 

Only  in  very  few  cases,  where  acquired  contrary  sexual 


1  With  reference  to  prophylaxis,  the  following  words,  which  were  written  to  me  by 
the  subject  of  Case  88  of  the  sixth  edition,  are  noteworthy  :  "If  it  were  only  possible  that 
— not  as  among  the  Spartans,  where  the  weaklings  were  allowed  to  perish  for  the  sake  of 
perfect  selection,  in  accordance  with  the  Darwinian  idea — our  contrary  sexual  instincts 
might  be  recognized  early  in  youth  ;  and  if  it  were  only  possible  that,  at  this  time  of  life, 
the  worst  of  all  diseases  could  be  cured  by  suggestion  !  Probably  cure  could  be  more 
easily  effected  in  youth  than  later." 

21 


322  PSYCHOPATHIA   SEXUALIS. 

instinct  has  not  progressed  far,  can  the  fulfillment  of  1  and  2 
be  sufficient,  as  the  following  case,  fully  reported  by  the  author 
in  the  Irrenfreund,  1884,  No.  1,  proves: — 

Case  132.  Count  Z.,  aged  51,  of  psychopathic  mother,  was  early 
sent  to  a  military  school,  and  there  was  taught  onanism.  He  developed 
well,  and  had  normal  sexual  feelings,  but,  as  a  result  of  masturbation,  he 
became  somewhat  neurasthenic  in  his  seventeenth  year.  He  enjoyed 
intercourse  with  women,  was  married  at  twenty-five,'  but  after  a  year 
more  became  neurasthenic,  and  absolutely  lost  his  -inclination  for 
women.  In  its  place  came  contrary  sexual  instinct.  Involved  in 
an  accusation  for  high  treason,  he  was  sent  to  prison  for  two  years, 
and  then  to  Siberia  for  five  years.  In  these  seven  years,  under  the 
influence  of  continued  masturbation,  neurasthenia  and  contrary  sexual 
instinct  constantly  increased.  With  his  freedom  restored  at  the  age  of 
thirty-five,  the  patient  began  to  visit  all  kinds  of  health-resorts  on  account 
of  his  great  neurasthenia ;  and  this  has  since  been  his  occupation.  In  all 
these  years  his  abnormal  sexual  feeling  has  not  changed  in  any  way. 
For  the  most  part,  he  lived  away  from  his  wife,  whom,  it  is  true,  he 
esteemed  for  her  mental  qualities  ;  though  he  avoided  her,  as  he  did  every 
other  woman.  His  contrary  sexual  feeling  is  purely  platonic.  "  Friend- 
ship," sweet  embraces,  and  kisses  sufficed  him.  Pollutions,  which  occasion- 
ally occurred,  were  induced  by  lascivious  dreams  which  had  for  subject 
persons  of  his  own  sex.  Also,  during  the  day,  the  most  beautiful  woman 
had  no  charm  for  him,  while  simply  the  sight  of  handsome  men  induced 
erection  and  ejaculation.  Only  athletes  and  male  dancers  in  the  circus 
and  ballet  interested  him.  At  times  of  greater  excitability,  even  masculine 
statues  gave  him  erections.  Now  and  again  he  resumed  his  old  vice  of 
masturbation.     This  man  of  aesthetic  culture  had  a  horror  of  pederasty. 

He  felt,  always,  that  his  perverse  sexual  feeling  was  something 
abnormal,  without,  however,  in  his  apparently  much  weakened  libido  and 
virility,  feeling  unhappy. 

The  examination  gave  the  usual  findings  of  neurasthenia.  De- 
velopment, manner,  and  attire  presented  nothing  remarkable.  Electrical 
massage  was  unusually  successful.  After  a  few  sittings  the  patient  was 
mentally  and  physically  much  better.  After  twenty  sittings  libido  was 
again  awakened,  not  in  the  same  way,  but  normally,  as  the  patient  had 
felt  until  his  twenty-fifth  year.  Lascivious  dreams  were  concerned  only 
with  women ;  and  one  day  the  patient  joyfully  gave  the  information  that 
he  had  had  coitus,  and  that  he  had  had  the  same  natural  feeling  in  it  that 
he  had  had  twenty-six  years  before.  He  then  began  to  live  with  his  wife 
again,  and  hoped  that  he  was  lastingly  freed  from  neurasthenia  and  con- 
trary sexual  instinct.  His  hope  was  fulfilled  for  the  six  years  during 
which  I  was  able  to  keep  the  patient  under  observation. 


THERAPY.  323 

As  a  rule,  physical  treatment,  even  though  it  be  re-inforced 
morally  by  good  advice  with  reference  to  the  avoidance  of  mas- 
turbation, the  repression  of  homo-sexual  feelings  and  impulses, 
and  the  encouragement  of  hetero-sexual  desires,  will  not  prove 
sufficient,  even  in  cases  of  acquired  contrary  sexual  instinct. 

Here  a  method  of  mental  treatment — hypnotic  suggestion 
— is  all  that  can  bring  benefit. 

The  following  case  is  interesting ;  and  it  is  an  example  of 
successful  auto-suggestion  that  gives  encouragement  for  the 
milder  forms  of  the  anomaly : — 

Case  133.  Autobiography  of  a  Psychical'Hermaphrodite.  Success- 
ful Struggle  against  Homo-sexual  Inclinations  made  by  the  Patient  himself. 
— "  My  father  once  had  a  stroke,  but  has  recovered  save  for  paralysis 
of  the  face.  My  mother  was  very  anaemic  and  melancholic.  Both  suf- 
fered severely  with  haemorrhoids,  and  my  father  ascribed  to  this  trouble 
the  lumbar  pain  with  which  he  suffered  from  time  to  time  after  his 
marriage. 

"  I  am,  if  I  may  so  express  myself,  a  passive  character.  When  a 
child,  I  indulged  in  all  kinds  of  fancies,  religious  as  well  as  others.  I 
suffered  with  incontinence  of  urine,  and  it  is  said  that  in  sleep  I  handled 
my  genitals,  so  that  my  father  fastened  my  hands  to  the  bed!  (I  was 
then  a  mere  child,  and  had  not  masturbated.)  I  was  always  very  shy  and 
embarrassed  in  social  intercourse.  When  about  fourteen  or  fifteen  years 
old,  I  was  seduced  into  onanism.  The  impulse  and  desire  for  women, 
occurring  in  connection  with  the  awakening  sexual  feeling,  were,  in 
reality,  only  of  a  platonic  nature ;  I  was  also  without  the  society  of 
ladies.  When  about  eighteen,  I  attempted  to  satisfy  my  sexual  desire  in 
the  natural  way,  more  in  obedience  to  a  feeling  of  curiosity  than  from 
inner  longing.  Since  that  time,  without  having  experienced  any  real  in- 
clination for  women,  as  often  as  possible  I  have  satisfied  my  desire  by 
means  of  sexual  intercourse. 

"  Soon  after  puberty  I  became  very  anaemic,  and  appeared  much 
older  than  I  realty  was.  Then  came  melancholic  and  peculiar  ideas.  It 
was  a  delight  to  me  to  fancy  myself  humiliated  in  the  extreme.  It  may 
be  of  interest  to  add  that,  at  that  time,  I  was  troubled  with  religious 
doubts,  and  only  later  found  the  courage  to  rise  above  religions.  I  fell 
in  love  with  young  men.  At  first  I  opposed  these  ideas  ;  later  they  be- 
came so  powerful  that  I  became  a  genuine  urning.  Women  seemed  to  me 
to  be  human  beings  of  the  second  class.  I  was  in  a  state  of  despair.  My 
sickened  soul  was  filled  with  taedium  vitae  and  thoughts  inimical  to 
humanity.  One  day  I  read  :  '  What  will  it  come  to  ? '  And  ere  I  knew  it,  I 
was  a  socialist ;  but  an  ideal  one.     Life  again  had  value  for  me,  for  I  had 


324  PSYCHOPATHIA   SEXUALIS. 

an  ideal, — the  joyous  struggle  for  the  social  elevation  of  the  proletariat. 
This  caused  a  powerful  revolution  in  me.  As  in  my  best  years  (from 
the  age  of  sixteen  to  seventeen),  I  took  interest  in  art,  particularly  in 
dramatic  art.  I  am,  at  the  present  time,  writing  a  play  and  a  story,  and 
I  am  occupied  with  the  grandest  thoughts.  I  read  a  remark  of  Schlegel's 
concerning  Sophocles,  who  was  indebted  to  his  physical  exercise  for  his 
energy  and  creative  power,  and  to  music  for  his  artistic  proportions.  In 
another  place  I  read:  '  The  dramatist  must,  above  all  things,  be  mentally 
intact.'  This  depressed  me;  for  my  contrary  sexual  feelings  could  not 
arise  in  a  perfectly  normal  mind. 

"  I  thought  of  having  myself  treated  hypnotically ;  but  shame  held 
me  back.  Then  I  said  to  myself  that  I  was  a  weakling,  indeed,  to  have  so 
little  confidence  in  myself„ and  began  in  earnest  to  combat  my  abnormal 
desires.  At  the  same  time,  I  struggled  against  my  nervousness  by  lead- 
ing the  proper  kind  of  a  life.  I  rowed,  fenced,  and  was  much  in  the  open 
air ; «  and  I  was  delighted  when,  at  last,  I  awoke  and  seemed  to  be  an 
entirely  different  man.  When  I  thought  of  the  time  from  my  twentieth 
to  my  twenty-sixth  year,  it  seemed  to  me  that,  during  those  years,  a 
strange  and  depressive  being  had  been  dwelling,  within  me. 

"  I  was  astonished  that  the  handsomest  rider  or  the  trimmest  waiter 
excited  in  me  almost  no  interest ;  even  the  muscular  masons  had  no  effect 
on  me.  I  was  disgusted  when  I  thought  that,  at  one  time,  such  men  had 
seemed  handsome  to  me.  My  self-respect  increased  ;  I  am  good-natured, 
but  my  character  is  entirely  active.  Since  my  twentieth  year  my  ap- 
pearance has  steadily  improved.  My  appearance  now  corresponds  per- 
fectly with  my  years.  There  were  recurrences  of  my  abnormal  inclina- 
tions, to  be  sure ;  but  I  struggled  against  them  energetically.  I  satisfy 
my  libido  only  by  means  of  natural  intercourse,  and  I  hope  that,  by  con- 
tinuing to  lead  a  proper  life,  my  pleasure  in  natural  coitus  will  increase." 

As  a  rule,  only  suggestion  coming  from  a  second  person, 
and  that  by  means  of  hypnosis,  promises  any  success.  In  such 
cases,  the  object  of  post-hypnotic  suggestion  is  to  remove  the 
impulse  to  masturbation  and  homo-sexual  feelings  and  impulses, 
and  to  encourage  hetero-sexual  feelings  with  a  sense  of  virility. 
A  prerequisite  is,  of  course,  the  possibility  to  induce  hypnosis 
of  sufficient  intensity.  It  is,  unfortunately,  in  these  very  cases 
of  neurasthenia  that  this  is  impossible,  since  they  are  often 
excited,  embarrassed,  and  in  no  condition  to  concentrate  their 
thoughts. 

Thus,  in  a  case  reported  by  me  in  the  International.  Gen- 
tralblatt  fur  die  Physiologie   und  Pathologie  der  Ham-   und 


THERAPY.  325 

Sexuatorgane,  Bd.  i,  Heft  2,  p.  58,  it  was  impossible  for  me  to 
induce  hypnosis,  though  the  patient  desired  it,  and  did  every- 
thing to  make  it  successful.  By  reason  of  the  great  benefit 
that  can  be  given  to  such  unfortunates,  and  with  Ladame's 
case  in  view  (v.  infra),  in  the  future,  in  all  such  cases,  every- 
thing should  be  done  to  bring  about  hypnosis, — the  only 
means  of  salvation.  The  result,  in  the  three  following  cases, 
was  satisfactory : — 

Case  134.  Contrary  Sexual  Instinct  Acquired  through  Masturba- 
tion.— Mr.  X.,  merchant,  aged  29.  Father's  parents  healthy.  Nothing- 
nervous  in  father's  family.  Father  was  an  irritable,  peevish  old  man. 
One  brother  of  the  father  was  a  man-abont-town,  and  died  unmarried. 
Mother  died  in  third  confinement,  when  the  patient  was  six  years  old ; 
she  had  a  deep,  rough,  masculine  voice,  and  coarse  appearance.  Of  the 
children,  one  brother  is  irritable,  "  melancholic,"  and  indifferent  to 
women. 

When  a  child  patient  had  scarlet  fever  with  delirium.  Until  his 
fourteenth  year  he  was  light-hearted  and  social,  but,  after  that,  quiet, 
solitary,  and  "  melancholic."  The  first  trace  of  sexual  feeling  appeared 
in  his  tenth  or  eleventh  year,  and  at  that  time  he  learned  masturbation 
from  other  boys,  and  practiced  mutual  onanism  with  them.  At  the  age 
of  thirteen  or  fourteen,  ejaculation  for  the  first  time.  Patient  has  felt 
no  evil  results  of  onanism  until  the  last  three  months. 

In  school  he  learned  easily,  but  was  troubled  with  headaches. 
After  the  age  of  twenty,  pollutions,  in  spite  of  daily  practice  of  onanism. 
With  pollutions,  "  procreative  "  dreams,  as  man  and  wife  might  perform 
the  act,  occurred.  In  his  seventeenth  year  he  was  seduced  into  mutual 
onanism  by  a  man  having  a  love  for  men.  He  found  satisfaction  in  this, 
inasmuch  as  he  was  always  very  passionate  sexually.  It  was  a  long  time 
before  the  patient  again  sought  new  opportunities  for  intercourse  with 
males.  He  did  it  simply  to  rid  himself  of  semen.  He  felt  no  friendship 
or  love  for  the  person  with  whom  he  had  intercourse.  He  felt  satisfac- 
tion only  when  he  played  the  passive  role, — when  manustnpration  was 
practiced  on  him.  When  the  act  was  once  completed,  he  had  no  respect 
for  the  individual.  If  it  happened  that,  later,  he  came  to  respect  the 
man,  then  he  ceased  to  indulge  in  the  act  with  him.  Later  it  became 
indifferent  to  him  whether  he  masturbated  or  had  masturbation  practiced 
on  him.  When  he  himself  practiced  onanism,  he  always  thought  of 
pleasing  men  practicing  onanism  on  him  during  the  act.  He  preferred 
a  hard,  rough  hand. 

The  patient  thought  that,  had  he  not  been  led  astray,  he  would  have 
arrived  at  a  natural  mode  of  satisfaction  of  his  sexual  desires.    He 


336  PSTCHOPAIfflA  sextaiisl 

never  felt  lore  for  his  own  sex,  though  he  had  pleased  himself  with  the 
thought  of  loving  men.  At  first  he  had  had  sensual  inclinations  toward 
the  opposite  sex.  He  had  taken  pleasure  in  dancing,  and  he  had  been 
pleased  with  women,  but  he  had  taken  more  pleasure  in  the  figure  than 
the  face.  Too.  he  had  had  erections  at  the  sight  of  women  that  pleased 
him.  He  had  never  attempted  coitus,  for  fear  of  infection ;  whether  he 
was  potent  or  not  with  women,  he  did  not  know.  He  thought  he  could 
be  so  no  longer,  because  his  feeling  for  women  had  grown  cold,  especially 
during  late  Years. 

While  previously,  in  his  sensual  dreams,  he  had  had  ideas  of  both 
men  and  women,  of  late  years  he  had  dreamed  only  of  approaches  to  men ; 
he  could  not  remember  that  he  had  dreamed,  in  late  years,  of  sensual  rela- 
tions with  a  woman.  At  the  theatre,  as  well  as  in  the  circus  and  ballet, 
the  feminine  figure  had  always  interested  him.  In  museums  masculine 
and  feminine  statues  had  affected  him  equally. 

Patient  is  a  great  smoker,  a  beer-drinker,  loves  male  society,  and  is 
a  gymnast  and  skater.  Anything  dandified  was  repugnant  to  him,  and 
he  had  never  felt  any  desire  to  please  men ;  he  would  even  have  preferred 
to  please  women. 

He  now  felt  his  position  to  be  painful,  because  onanism  had  ob- 
tained the  upper  hand.  Masturbation,  that  had  previously  been  practiced 
without  evil  effects,  now  began  to  disclose  its  bad  results. 

Since  July,  1889,  he  had  suffered  with  neuralgia  of  the  testicles. 
The  pain  occurred  particularly  at  night ;  and  at  night  there  was  also 
trembling  (increased  reflex  excitability). 

Sleep  was  not  refreshing,  and  he  would  wake  up  with  pain  in  the 
tcgflcJgsi  He  was  inclined,  now,  to  indulge  more  frequently  in  onanism. 
He  was  afraid  of  the  consequences  of  the  habit.  He  hoped  that  his 
sexual  fife  might  still  be  turned  into  normal  channels,  Xow,  he  thought 
of  the  future ;  he  had  a  relation  with  a  girl,  who  was  attractive  to  him, 
and  the  thought  to  possess  her  as  a  wife  was  pleasing. 

For  five  days  he  had  abstained  from  onanism,  but  he  could  scarcely 
believe  that  he  would  be  able,  with  his  own  strength,  to  overcome  the 
habit.  Of  late  he  had  been  very  much  depressed,  having  lost  all  desire 
for  work,  and  become  tired  of  fife. 

Patient  is  tall,  powerful,  well  nourished,  and  has  a  thick  growth  of 
beard.  Skull  and  skeleton  normal.  Kneejerks  very  prompt ;  deep  re- 
flexes in  upper  extremities  much  increased.  Pupils  dilated,  equal,  and 
act  promptly.  Carotids  of  equal  calibre ;  hyperesthesia  urethra? ;  cords 
and  testicles  not  sensitive :  genitals  normal. 

The  patient  was  calmed,  and  given  hope  for  the  future,  provided 
that  he  give  up  onanism  and  attempt  to  transfer  his  sexual  desires  from 
persons  of  his  own  sex  to  females. 

Hip-baths  (24°  to  20°  R.) ;  ext.  secal  count,  aquos..  0.5 ;  antipyrin, 
1,0  (pro  die) ;  pot.  brom..  4.0  (evenings),  wexe  ordered. 


THERAPY.  327 

December  13th.  To-day  the  patient  came,  in  a  disturbed  condition 
of  mind,  complaining  that,  unaided,  he  was  unable  to  resist  the  impulse 
to  masturbate,  and  he  asked  for  help. 

A  trial  of  hypnosis  induced  a  condition  of  deep  lethargy  in  the  patient. 

He  was  given  the  following  suggestions  : — 

1.  I  can  not,  must  not,  and  will  not  masturbate  again. 

2.  I  abhor  the  love  for  my  own  sex,  and  shall  never  again  think 
men  handsome. 

3.  I  shall  and  will  become  well  again,  fall  in  love  with  a  virtuous 
woman,  be  happy,  and  make  her  happy. 

December  14th.  While  out  walking  to-day,  patient  saw  a  handsome 
man,  and  felt  himself  powerfully  drawn  toward  him. 

From  this  time  there  were  hypnotic  sittings  every  second  day, 
with  the  above  suggestions. 

December  18th  (fourth  sitting),  somnambulism  occurred;  the  im- 
pulse to  onanism  and  interest  in  men  disappear. 

At  the  eighth  sitting  "  complete  virility  "  was  added  to  the  above 
suggestions.  The  patient  feels  himself  morally  elevated  and  physically 
strengthened.  The  neuralgia  of  the  testicles  has  disappeared.  He  now 
found  that  he  was  without  sexual  feeling. 

He  now  believed  himself  free  from  masturbation  and  contrary 
sexual  inclination. 

After  the  eleventh  sitting  he  thought  that  further  help  was  un- 
necessary. He  wished  to  go  home,  and  marry.  He  felt  well  and  potent. 
Early  in  January,  1890,  treatment  ceased. 

In  March,  1890,  the  patient  wrote:  "I  have  since  had  several  occa- 
sions on  which  it  has  been  necessary  for  me  to  use  all  my  moral  strength 
in  order  to  overcome  my  habit,  and,  thank  God,  I  have  been  successful 
in  freeing  myself  from  this  vice.  Several  times  I  have  had  opportunity 
for  sexual  intercourse,  and  I  have  found  pleasure  in  it.  I  look  calmly 
on  my  happy  future." 

Case  135.  Acquired  Contrary  Sexual  Instinct.  Marked  Improve- 
ment under  Hypnotic  Treatment. — Mr.  P.,  born  in  1863,  official  in  a 
manufactory.  He  comes  of  a  highly  respected  patrician  family  of 
Middle  Germany,  in  which  nervousness  and  insanity  have  been  of 
frequent  occurrence. 

His  great-grandfather  on  the  father's  side  and  his  sister  died  in- 
sane ;  the  grandmother  died  of  apoplexy ;  father's  brother  died  insane, 
and  a  daughter  of  the  latter  died  of  cerebral  tuberculosis.  The  maternal 
grandmother  was  melancholic  for  years ;  maternal  grandfather,  insane. 
A  maternal  uncle  took  his  life  in  an  attack  of  insanity.  The  patient's 
father  is  very  nervous.  An  elder  brother  is  very  neurasthenic,  and  has 
anomalies  of  the  vita  sexualis ;  another  is  the  subject  of  Case  155  ;  a  third 
is  eccentric  in  conduct,  and  is  said  to  be  subject  to  fixed  ideas.  A  sister 
suffers  with  convulsions,  and  another  died  of  them  when  a  little  child. 


328  PSYCHOPATHIA   SEXUALIS. 

The  patient  is  constitutionally  predisposed ;  for  he  was  early  very 
peculiar,  irritable,  irascible,  and  impressed  those  around  him  as  being 
abnormal. 

His  vita  sexualis  appeared  very  early  and  in  great  intensity,  and 
was  satisfied,  without  any  seductions,  in  onanism.  From  his  sixteenth 
year  the  prematurely  developed  boy  visited  brothels  of  the  Capital,  using 
his  permissions  to  go  out  on  Sundays  and  holidays  for  that  purpose.  He 
took  pleasure  in  coitus,  but  during  the  week  he  satisfied  himself  with 
onanism.  After  his  twentieth  year,  when  he  became  independent,  the 
patient  indulged  with  prostitutes  excessively,  and  fell  ill  with  neurasthe- 
nia sexualis,  becoming  relatively  impotent  and  unsatisfied  in  coitus,  owing 
to  weakness  of  erection  and  premature  ejaculation.  His  sexual  libido 
became  more  powerful  than  ever,  and  was  satisfied  in  onanism.  Early  in 
1888  the  patient  made  the  acquaintance  of  a  young  man.  "  By  his  pleas- 
ing face,  his  attractive  manner,  and  his  beautiful  form,  he  conquered  me 
entirely.  I  wished  to  speak  to  him,  and  was  happy  at  mere  sight  of  him. 
I  was  completely  in  love  with  him.  With  this,  my  love  for  women  was 
extinguished.  Any  man  could  excite  me  to  such  an  extent  that,  for  some 
moments,  I  would  feel  my  memory  fail,  and  I  would  stammer. 

"  Soon  after  this  I  made  the  acquaintance  of  a  gentleman  who  was 
likewise  very  attractive,  and  who  had  a  decided  influence  on  my  future 
life.  He  was  male-loving.  I  confessed  to  him  that  I  no  longer  felt  any- 
thing but  aversion  for  the  female  sex,  and  that  I  was  attracted  to  men. 

"  When  I  once  asked  my  companion  how  he  brought  it  about  that 
soldiers  would  surrender  themselves  to  him,  he  answered  that  the  princi- 
pal thing  was  skill ;  almost  any  of  them  could  be  brought  to  it.  Late  in 
1888,  thinking  of  these  words,  I  was  attracted  by  an  officer's  servant,  and 
was  intensely  excited  by  him,  but  ejaculation  never  occurred.  Since  I 
saw  that  the  soldier  would  surrender  himself  without  trouble,  I  ap- 
proached him.  Alium  quondam  militem  in  cubiculum  allectum  rogavi 
ut  veste  exuta  mecum  in  lectum  concumberet.  Rogatus  fecit  quae  volui 
et  alter  alterius  pen  em  trivit. 

"  Though  after  this  success  I  misused  many  persons,  I  was  never 
really  in  love,  so  to  speak,  with  but  one.  He  was  a  very  handsome  young 
fellow  of  seventeen.  His  voice  was  so  attractive  to  me,  and  his  manner 
was  so  delicately  proper,  that  I  cannot  forget  him.  In  my  dreams  I 
thought  only  of  handsome  young  men,  and  often  for  whole  nights  I  could 
not  sleep,  owing  to  sensual  feeling." 

Early  in  1889  the  patient's  conduct  awakened  a  suspicion  of  male- 
love.  A  threatening  communication  frightened  him,  and  plunged  him  in 
deep  depression,  so  that  he  contemplated  suicide.  At  the  advice  of  the 
family  physician,  he  came  to  the  Capital.  Since  the  patient  was  unable 
to  overcome  his  habitual  desires  by  his  own  will,  hypnotic  treatment 
was  undertaken.  It  induced  but  mild  lethargy,  and,  in  opposition  to  the 
seduction  of  former  lovers,  it  had  but  little  effect. 


THERAPY.  329 

At  that  time  the  patient  was  wanting  in  earnest  desire.  There  was 
some  improvement  in  matters,  in  the  face  of  the  disgrace  to  relatives  and 
the  prospect  of  a  legal  examination  that  was  actually  threatening.  The 
patient  determined  to  attempt  a  cure  with  the  author. 

I  found  him  to  be  a  delicate,  pale,  very  neurasthenic  man,  much  de- 
pressed, and  despairing  about  the  future.  He  was  without  degenerative 
signs.  He  realized  his  perverted  situation,  and  seemed  to  be  willing  to 
do  anything  in  order  to  become  again  a  decent,  moral  man. 

He  regretted  exceedingly  his  sexual  perversion,  which  he  regarded 
as  abnormal,  but  also  as  having  been  acquired.  He  made  no  attempt  to 
conceal  the  fact  that  he  could  not  control  himself  with  young  men,  and 
likewise  he  would  not  say  that  he  could  abstain  from  onanism,  to  which, 
faute  de  mieux,  he  was  driven.  Only  a  powerful,  imperious  will  could 
keep  him  from  it. 

Thus  far  his  male-love  had  consisted  exclusively  of  mutual  onanism. 
Erections  occurred  only  when  touching  men  he  loved  ;  ejaculation  re- 
sulted early,  but  simple  embrace  was  not  sufficient.  He  had  never  felt 
himself  in  any  particular  sexual  role  toward  a  man.  Genitals  and 
vegetative  organs  normal. 

In  addition  to  treatment  directed  to  his  neurasthenia,  on  April  8, 
1890,  hypnotic  suggestion  was  begun.  Hypnosis  was  easily  induced  by 
simply  looking  at  him,  with  verbal  suggestion.  After  a  half-minute  the 
patient  passed  into  deep  lethargy,  with  a  cataleptiform  state  of  the 
muscles.  The  awakening  was  brought  about  by  suggesting  it  at  count- 
ing three.  Post-hypnotic  suggestions  were  always  successful.  The 
intra-hypnotic  suggestions  were  : — 

1.  The  interdiction  of  onanism. 

2.  The  command  that  male-love  should  be  felt  to  be  disgraceful  and 
despicable,  and  that  it  should  be  impossible. 

3.  The  command  to  regard  only  women  as  beautiful ;  to  approach 
them,  to  dream  of  them,  and  to  have  libido  and  erection  at  sight  of 
them. 

The  sittings  occurred  daily.  On  April  14th,  the  patient  announced, 
with  thankfulness  and  a  kind  of  moral  satisfaction,  that  he  had  had 
pleasure  in  coitus,  and  had  ejaoulated  tardily.  On  April  16th,  he  felt 
free  from  inclination  to  masturbate,  attracted  to  women,  and  perfectly 
indifferent  to  men.  He  dreamed  of  female  charms  and  coitus  with 
women.  May  1st,  the  patient  seemed  and  felt  himself  to  be  normal 
sexually.  He  has  become  a  different  man  mentally,  full  of  courage  and 
self-confidence.  He  has  coitus  with  complete  satisfaction,  and  thinks 
that  he  is  insured  against  relapse. 

In  a  later  letter  Mr.  P.  writes :  "  As  was  only  to  be  expected,  I 
find  myself  lastingly  freed  from  my  errors.  All. that  remains  to  remind 
me  of  my  unhappy  time  are  the  dreams,  which,  though  they  are 
infrequent,  come  from  my  past,  which  I  have  no  power  to  banish,  and 


330  PSYCHOPATHIA   SEXUALlS. 

which  sometimes,  indeed,  pleasantly  occupy  my  thoughts.  But  by  my 
own  will  I  yet  hope  soon  to  succeed  in  freeing  myself  absolutely  from 
them.  Should  I  ever  become  weak  again,  the  ideas  you  have  im- 
pressed on  me  would,  I  am  sure,  make  an  energetic  resistance,  and  I 
should  not  succumb." 

On  October  20, 1890,  P.  wrote  me:  "I  am  completely  cured  of 
onanism,  and  I  have  no  pleasure  in  male-love.  Yet  complete  virility 
does  not  seem  to  have  been  re-established,  notwithstanding  the  fact  that 
I  lead  a  virtuous  life.     Nevertheless,  I  feel  satisfied." 

Case  136.  Acquired  Contrary  Sexual  Instinct. — Mr.  Z.,  aged  32, 
divorced.  He  comes  of  a  hysteropathic  mother.  Maternal  grandmother 
suffered  with  hysteria,  and  her  brothers  and  sisters  were  neurotic.  One 
brother  is  an  urning.  Z.  was  but  poorly  endowed  mentally,  and  did  not 
learn  easily.  No  sickness  besides  scarlatina.  When  thirteen,  he  was 
taught  to  masturbate  by  companions  in  a  school.  Sexualby,  he  was 
hypersesthetic,  and,  at  seventeen,  began  to  indulge  in  coitus,  with  full 
pleasure  and  power.  For  reasons  of  position  and  money,  he  married  at 
twenty -six.  The  marriage  was  very  unhappy.  After  a  year  Mrs.  Z. 
became  incapable  of  coitus,  by  reason  of  uterine  disease.  Z.  satisfied 
his  inordinate  desires  with  other  women,  faute  de  mieux,  by  masturba- 
tion. Besides,  he  gave  himself  up  to  play,  led  an  absolutel}'  dissolute 
life,  became  exceedingly  neurasthenic,  and  sought  to  strengthen  his 
weakened  nerves  by  drinking  great  quantities  of  wine  and  brandy.  To 
his  essential  cerebral  asthenia  were  added  peripheral  alcoholic  cramps 
and  globus,  and  he  became  very  emotional.  His  libido  nimia  continued 
unabated.  On  account  of  his  disgust  of  prostitutes  and  fear  of  infection, 
satisfaction  by  coitus  was  exceptional.*  For  the  most  part,  the  patient 
helped  himself  with  onanism. 

Four  years  ago  he  noticed  weakening  of  erection  and  decrease  of 
libido  for  women.  He  began  to  feel  himself  drawn  toward  men,  and  his 
lascivious  dreams  were  no  longer  concerned  with  women,  but  with  men. 

Three  37ears  ago,  while  being  rubbed  by  a  bath-attendant,  he  became 
powerfully  excited  sexually  (the  attendant  also  had  an  erection,  to  pa- 
tient's surprise).  He  could  not  keep  from  embracing  and  kissing  the 
attendant,  and  allowing  him  to  perform  masturbation  on  him,  the 
attendant  doing  it  most  willingly.  From  this  time  this  mode  of  sexual 
indulgence  was  all  that  he  cared  for.  Women  became  a  matter  of  entire 
indifference  to  him  ;  he  devoted  himself  exclusively  to  men.  With  them 
he  practiced  mutual  masturbation,  and  had  a  longing  to  sleep  with  them. 
He  abhorred  pederasty.  He  was  entirely  satisfied  until  (August,  1890) 
an  anonymous  letter,  warning  him  to  be  careful,  brought  him  to  his 
senses.  He  was  much  frightened,  had  hysterical  attacks,  and  became 
much  depressed.  He  was  embarrassed  before  men,  seemed  like  a  pariah 
in  society,  contemplated  suicide,  and  finalby  confessed  to  a  priest,  who 
comforted  him.     He  now  fell  into  a  religious  state  (equivalent),  and,  out 


THERAPY.  331 

of  remorse  and  to  cure  himself  of  his  abnormal  sexual  inclinations,  wished 
to  go  into  a  cloister.  While  in  this  state,  my  "  Psychopathia  Sexualis  " 
fell  into  his  hands.  He  was  frightened  and  filled  with  shame,  but  found  a 
comfort  in  it,  inasmuch  as  he  concluded  that  he  must  have  some  malady. 
His  first  thought  was  to  rehabilitate  himself  sexually  in  his  own  eyes. 
He  overcame  all  disinclination,  and  visited  a  brothel.  At  first  he  was 
not  successful,  on  account  of  great  excitement,  but  he  finally  succeeded. 

Since,  however,  his  contrary  sexual  inclinations  were  not  overcome, 
in  spite  of  all  his  efforts  to  put  them  down,  he  finally  came  to  me,  asking 
for  assistance.  He  felt  himself  to  be  terribly  unfortunate,  and.  very  near 
to  despair  and  suicide.  He  saw  destruction  before  him,  and  would  be 
saved  at  any  price. 

His  confession  was  interrupted  by  numerous  hysterical  attacks. 
Comforting  and  encouraging  words  about  his  future  had  a  calming 
influence. 

Physically,  patient  presented  a  slightly  retreating  brow,  with  no 
other  anatomical  signs  of  degeneration.  Spinal  irritation,  exaggerated 
deep  reflexes,  and  a  sense  of  pressure  in  the  head  pointed  to  a  neuras- 
thenic condition.  No  genital  anomalies,  though  there  was  hyperesthesia 
urethrse.  Mien  distressed;  attitude  relaxed  ;  mind  distracted  and  vacil- 
lating. 

Hip-baths,  massage,  ergot  with  antipyrin  and  pot.  brom.,  ordered, 
with  interdiction  of  onanism,  intercourse  with  men,  and  lascivious 
thoughts  of  them. 

After  a  few  days  the  patient  came  complaining  that  he  was  not 
equal  to  the  task.  He  said  his  will  was  too  weak.  In  this  precarious 
situation,  it  seemed  that  nothing  but  hypnotic  treatment  could  bring 
improvement. 

September  11,  1889.  First  sitting.  Bernheim's  method  used,  in 
order  to  induce  lethargy  as  quickly  as  possible. 

Suggestions  : — 

1.  I  abhor  onanism,  and  will  not  masturbate  again. 

2.  I  regard  the  inclination  for  men  disgusting, — horrible;  and  I 
shall  never  think  men  handsome  and  enticing. 

3.  Women  alone  I  find  enticing.  Once  a  week  I  shall  cohabit, 
with  full  pleasure  and  power. 

The  patient  received  these  suggestions,  and  repeated  them  in  a 
drawling  tone. 

The  sittings  took  place  every  second  day.  After  the  fifteenth,  it 
was  possible  to  induce  the  somnambulic  stage  of  h}*pnosis  with  any  post- 
hypnotic suggestions  desired. 

The  patient  improved  morally  and  mentally,  but  symptoms  of  cere- 
bral neurasthenia  troubled  him  still,  and,  now  and  then,  dreams  of  men 
occurred;  and  there  were,  also,  in  the  waking  state,  inclinations  toward 
men,  which  depressed  him  exceedingly. 


332  PSYCHOPATHIA   SEXUALlS. 

.Treatment  until  September  24th.  Result :  Free  from  onanism ; 
no  longer  excitable  to  men,  though  impressionable  to  women.  Normal 
coitus  once  in  eight  days.  Hysterical  symptoms  absent ;  neurasthenic 
symptoms  much  ameliorated. 

On  October  6th  the  patient  reported  by  letter  that  he  was  feeling 
well,  and  expressed  his  gratitude  for  his  salvation;  he  felt  as  if  given  a 
new  life. 

December  9,  1889,  patient  again  came  for  treatment.  Of  late  he 
had  had  lascivious  dreams  of  men  twice,  but  had  experienced  no  inclina- 
tion toward  men  in  the  waking  state.  He  had  also  resisted  the  impulse 
to  masturbate,  though,  while  living  alone  in  the  country,  he  had  had  no 
opportunity  for  coitus.  He  had  inclinations  only  for  the  opposite  sex, 
and,  as  a  rule,  dreamed  only  of  females.  Returned  to  the  city,  he  had 
indulged  in  coitus  with  pleasure.  The  patient  felt  himself  morally 
rehabilitated,  being  almost  free  from  neurasthenic  symptoms  ;  and,  after 
three  more  hypnotic  sittings,  he  declared  himself  perfectly  well,  and 
confident  that  he  would  not  relapse.  Such  a  relapse  occurred,  however, 
in  September,  1890,  when,  after  over-exertion  on  an  excursion  into  the 
mountains,  and  emotional  strain  with  want  of  opportunity  for  coitus,  he 
had  again  become  neurasthenic. 

Again  he  had  dreams  of  men,  and  felt  drawn  toward  attractive 
male  forms;  he  masturbated  many  times,  and,  after  returning  to  the 
city,  found  no  real  pleasure  in  coitus.  ISy  means  of  anti-neurasthenic 
treatment  and  hypnosis,  it  was  possible  soon  to  restore  the  previous 
condition. 

In  the  course  of  the  years  1890  and  1891  the  patient  now  and  then 
had  contrary  sexual  feelings  and  dreams,  but  only  when,  as  a  result  of 
emotional  strain  or  excesses,  his  neurosis  re-appeared.  At  such  times 
satisfaction  in  coitus  was  wanting.  He  would  then  find  it  necessary  to 
undergo  a  few  hypnotic  sittings,  in  order  to  restore  his  equilibrium — 
always  with  success. 

At  the  end  of  1891  the  patient  pointed  with  satisfaction  to  the 
fact  that,  since  treatment,  he  had  been  able  to  avoid  masturbation  and 
male-intercourse,  and  had  regained  his  self-confidence  and  self-respect. 

The  foregoing  details  of  the  successful  results  of  hypnotic 
suggestion,  in  cases  of  acquired  contrary  sexual  feeling,  make  it 
seem  possible  that  those  unfortunates  that  are  afflicted  with  the 
congenital  perversion  may  be  helped  in  some  degree  by  the 
same  means. 

To  be  sure,  here  the  condition  is  entirely  different,  since  a 
congenital  condition  must  be  combated,  an  abnormal  psycho- 
sexual  life  annihilated,  and  a  new  one  created.     A  priori  this 


THERAPY.  333 

task  seems  impossible;  at  least,  in  the  perfect  urning.  That  the 
apparently  impossible  is  artificially  possible  may  be  seen  from 
the  case  of  Schrenk-Notzing,  which  follows  below.  It  far  sur- 
passes the  case  reported  by  me  (v.  infra),  in  which  at  least  the 
homo-sexual  feelings  and  impulses  were  removed  by  means  of 
hypnotic  suggestion. 

The  case  of  Ladame  (v.  infra)  is  an  analogous  one.  The 
conditions  are  more  favorable  in  psycho-sexual  hermaphrodites, 
where  at  least  there  are  rudiments  of  hetero-sexual  feelings  that 
may  be  strengthened  and  made  operative  by  suggestion. 

Case  137.  "I  was  born  in  1858,  out  of  wedlock.  It  was  only  late 
that  I  was  able  to  trace  my  obscure  origin,  and  obtain  knowledge  of  my 
parents;  and  this  knowledge  is,  unfortunately,  very-obscure  and  imper- 
fect. My  father  and  mother  were  cousins.  My  father 'died  three  years 
ago.  He  had  later  married,  and,  as  far  as  I  know,  had  several  healthy 
children. 

.  "I  do  not  think  that  my  father  had  contrary  sexual  feelings. 
Without  knowing  him  as  my  father,  I  often  saw  him  when  I  was  a  child. 
He  was  a  powerful,  masculine  man.  As  for  the  rest,  it  is  said  that,  at 
the  time  of  my  birth,  or  before,  he  was  sexually  ill. 

"  I  have  often  seen  my  mother  on  the  street,  but  I  did  not  then 
know  that  she  was  my  mother.  At  the  time  of  my  birth  she  may  have 
been  about  twenty-four  37ears  old.  She  was  tall,  and  quick  and  energetic 
of  movement,  and  her  character  was  decided.  At  the  time  of  my  birth 
she  is  reported  to  have  gone  about  much  in  male  attire,  to  have  worn 
short  hair,  to  have  smoked  a  long  pipe,  and  in  general  to  have  been  re- 
markable for  her  eccentric  character.  She  was  exceedingly  well  edu- 
cated, and  is  said  to  have  been  beautiful  in  her  youth.  She  left  a  for- 
tune,— considerable  even  when  measured  by  our  present  ideas, — but  she 
died  unmarried. 

"  In  any  case,  all  this  would  point  to  homo-sexual  inclinations,  or, 
at  least,  to  abnormalities.  On  the  other  hand,  several  years  before  my 
birth,  my  mother  took  care  of  a  little  girl.  This  step-sister,  whom  I 
never  knew,  married  j-oung,  but  early  in  her  married  life,  for  reasons 
unknown  to  me,  she  poisoned  herself. 

"  I  am  1.7  metres  tall,  measure  92  centimetres  around  the  waist, 
and  102  centimetres  around  hips,  and,  therefore,  I  think  m}r  pelvis  is 
somewhat  over-developed.  The  subcutaneous  fat  has  always  been  abund- 
ant. Skeletal  form  is  strong.  The  muscular  system  is  well  formed,  but, 
from  lack  of  exercise,  perhaps  owing  to  the  influence  of  early,  long- 
continued,  and  frequent  indulgence  in  onanism,  it  is  not  well  developed ; 
so  that  I  appear  stronger  than  I  really  am.     Hair  of  head  and  face  is 


334  PSYCHOPATHIA   SEXUALIS. 

normal ;  genital  hair,  somewhat  thin.  The  upper  portion  of  the  body  is 
as  good  as  without  hair.  In  all  other  ways  my  appearance  is  fully  mas- 
culine. Gait,  attitude,  and  voice  are  those  of  a  fully  developed  man,  and 
other  urnings  have  often  told  me  that  they  would  never  have  suspected 
my  passion.  I  served  in  the  army,  and  always  found  pleasure  in  all 
knightly  exercises, — riding,  fencing,  swimming,  etc. 

"  My  early  training  was  under  a  priest.  I  had  but  few  real  play- 
mates. The  family  life  of  my  foster-parents  was  faultless.  In  October, 
1861, 1  entered  the  Institute.  Here  I  indulged  in  my  first  perverse  acts, 
which  I  shall  describe  more  fully  when  I  come  to  the  development  of  my 
sexual  life. 

"  I  finished  the  Gymnasium,  served  my  voluntary  j-ears  in  the  army, 
and  then  studied  forestry,  being  now  a  director  of  estates.  During  my 
early  years  my  mental  development  was  very  slow.  I  first  learned  to 
speak  in  my  third  year,  and  thus  the  supposition  that  I  had  hydrocepha- 
lus was  strengthened.  From  the  time  of  beginning  school,  my  mental 
development  was  abnormal ;  indeed,  I  learned  easily,  but  I  have  never 
been  able  to  concentrate  my  activity  on  any  particular  subject.  I  have 
a  great  interest  in  art  and  aesthetics,  but  almost  none  in  music.  In  early 
years  my  character  was  the  worst  possible.  Without  being  able  to  give 
any  reason  for  it,  during  the  last  twelve  3' ears  there  has  been  an  entire 
transformation.  Now,  there  is  nothing  I  hate  more  than  a  lie,  and  I 
never  speak  untruth  even  in  jest.  In  financial  matters,  without  being 
avaricious,  I  have  become  an  economical  manager. 

"  It  is  enough  that,  with  a  deep  feeling  of  shame,  I  look  back  on 
my  past;  and,  if  I  could  be  freed  from  mj-  unhappy  sexual  perversion,  or 
perversity,  I  should  justly  regard  myself  as  a  true  gentleman.  I  am 
kind,  and  alwaj's  ready  to  be  charitable  to  the  extent  of  my  means;  I 
am  gay-spirited,  and  regarded  with  favor  socially.  I  have  no  trace  of 
that  nervous  irritability  which  is  so  often  noticeable  in  others  like  me. 
Too,  I  am  not  wanting  in  personal  courage.  There  is  nothing  in  the 
early  period  of  my  development  that  points  to  abnormality.  To  be 
sure,  as  a  child,  I  liked  to  lie  in  bed  on  my  abdomen,  and,  of  a  morning, 
I  often  took  delight  in  rolling  about  on  my  abdomen,  much  to  the 
amusement  of  my  foster-parents ;  but  I  cannot  recall  that,  at  such  times, 
I  ever  had  sensual  feeling.  I  never  sought  much  to  play  with  girls,  and 
I  never  pla3*ed  with  dolls.  I  early  heard  talk  about  sexual  matters ;  but 
I  never  thought  anything  about  it.  In  my  dreams,  too,  at  that  time, 
there  was  nothing  sexual ;  and,  in  my  association  with  boys  of  my  own 
age,  there  was  nothing  of  that  kind.  I  think  I  may  say  that  my  vita 
sexualis  was  really  first  awakened  after  I  had  been  seduced  into  mutual 
masturbation,  in  my  thirteenth  year,  by  a  room-mate  at  the  Institute. 
At  that  time  ejaculation  did  not  take  place,  but  first  about  a  year  later. 
Nevertheless,  I  gave  mj-self  up  to  the  vice  of  onanism  passionately.  At 
this  time,  however,  the  first  signs  of  homo-sexual  inclination  were  mani- 


THERAPY.  335 

fested.  Youthful,  powerful  men,  market-helpers,  workmen,  and  soldiers 
took  possession  of  my  dreams,  and  played  an  important  role  in  my 
fancy  while  masturbating.  At  this  time  was  also  first  shown  the  ten- 
dency to  pederasty,  especially  passive.  Up  to  my  fourteenth  year  I 
frequently  made  mutual  attempts  at  pederasty  with  my  seducer,  but 
neither  of  us  were  successful  in  bringing  about  immissio.  At  the  same 
time,  there  was  also  a  weak  inclination  for  the  female  sex.  About  a  year 
after  the  first  indulgence  in  onanism,  I  was  once  with  a  puella  publica, 
but  I  had  neither  ejaculation  nor  any  especial  feeling  of  sensual  pleasure. 
Thereafter,  and  up  to  my  nineteenth  year,  I  performed  coitus  in  public 
houses  about  six  times.  Erection  and  ejaculation  occurred  promptly, 
but  without  marked  sensual  pleasure.  At  least  onanism,  particularly 
mutual  onanism,  I  liked  quite  as  much.  I  have  never  had  any  love 
for  athletes.  About  ten  years  ago,  while  at  H.,  a  watering-place,  I 
thought  I  was  in  love  with  a  beautiful  lad}"  of  a  highly  respectable 
famity ;  I  was  happy  in  her  presence,  and  thought  myself  happy  in  find- 
ing my  love  returned.  For  a  time  this  affair  kept  me  from  mastur- 
bating ;  I  was  only  afraid  that,  weakened  by  onanism  that  had  been 
practiced  for  years,  I  should  be  incapable  of  performing  my  marital 
duty.  When  we  became  widely  separated,  my  feeling  quickly  cooled  ;  I 
found  that  I  had  deceived  nryself ;  and,  after  about  two  3rears,  without 
jealousy,  I  was  able  to  hear  that  the  lady  had  married.  My  inclination 
for  women — if,  in  reality,  I  have  ever  had  airy — grew  colder  and  colder. 
Two  and  a  half  years  ago,  when  I  visited  a  public  house  with  very  virile 
friends,  I  last  performed  coitus.  There  was  erection,  but  no  ejaculation. 
Women  have  become  indifferent  to  me.  A  prostitute  who  acts  coarsely 
excites  my  repugnance.  With  intellectual  women,  particularly  when 
they  are  elderly,  I  like  to  converse,  but  in  their  society  I  am  often  un- 
skillful and  awkward,  often  devoid  of  tact.  I  have  never  been  able  to 
find  any  charm  in  woman's  physical  form. 

"  But,  to  return  to  the  perverse  inclinations.  When,  at  the  age  of 
fourteen,  I  went  to  H.,  I  lost  sight  of  my  lover  and  seducer.  He  was 
some  years  older  than  I,  and  was  an  official ;  and,  in  this  capacity,  when 
I  was  nineteen,  I  again  met  him  once  on  the  railway.  We  immediately 
cut  the  journey  short,  and  lodged  together,  attempting  mutual  pederasty ; 
but,  on  account  of  pain,  immissio  was  not  successful.  We  amused  our- 
selves in  mutual  onanism.  In  H.  I  had  sexual  intercourse  with  two 
fellow-students,  but  this  intercourse  was  confined  to  frequent  mutual 
onanism,  owing  to  the  fact  that  they  were  not  inclined  to  pederasty. 
During  the  last  jear  of  my  stay  (when  I  was  nineteen),  I  had  intercourse 
with  another  person,  which  likewise  consisted  of  onanism  ;  but  our  inter- 
course was  more  intimate,  and  we  always  retired,  and  practiced  mutual 
onanism  in  bed.  From  Easter,  1869,  until  July,  18T0,  I  had  no  lover.  I 
practiced  onanism  alone.  When  the  war  broke  out,  I  offered  myself  as  a 
volunteer,  but  was  not  accepted.     At  the  same  time  a  former  school- 


336  PSYCHOPATHIA    SEXUALIS. 

mate  offered  himself.  He  had  developed  into  a  remarkably  handsome 
man.  I  had  to  spend  one  night  with  him  in  an  over-crowded  hotel. 
Though  as  students  we  had  never  associated  sexually,  he  was  not 
averse  to  my  desire,  and  attempted  pederast}'.  In  this  instance  pain 
prevented  success ;  but,  in  the  attempt,  ejaculatio  ante  anum  meum  oc- 
curred. Even  now  I  can  recall  the  pleasurable  feeling  I  had  in  it, — a 
feeling  previously  unknown.  After  the  war  I  frequently  met  this  friend, 
but  our  intercourse  was  later  limited  to  onanism.  During  the  following 
eighteen  years  I  had  but  two  opportunities  for  homo-sexual  intercourse. 
The  first  was  in  the  winter  of  1819,  on  the  occasion  of  meeting  a  hand- 
some hussar  in  a  railway  carriage.  I  induced  him  to  sleep  with  me  at  an 
hotel.  Later  he  confessed  to  me  that  he  had  previously  practiced  mutual 
masturbation  with  the  son  of  a  landed  proprietor  of  his  town.  I  could 
not  bring  him  to  pederasty.  On  the  other  hand,  I  induced  ejaculation  in 
him  b}r  receptio  penis  ejus  in  os  meum.  This  caused  me  no  satisfaction, 
but  rather  disgust.  I  have  never  tried  it  again  ;  and,  too,  I  have  never 
allowed  receptio  penis  mei  in  os  alterius.  In  188*7,  likewise  on  the  rail- 
way, I  made  the  acquaintance  of  a  sailor,  and  induced  him  to  stay  with 
me  at  an  hotel.  He  said  he  had  never  practiced  pederasty,  but  he  was 
ready  for  it.  He  was  apparently  sensually  excited ;  he  had  an  erection 
immediately,  and  performed  the  act  with  evident  passion.  It  was  the  first 
time  that  pederasty  was  successfully  performed.  I  had  terrible  pain,  but 
also  indescribable  pleasure. 

"With  my  sojourn  here,  nry  vita  sexualis  has  undergone  a  complete 
change.  I  have  learned  how  easy  it  is  to  find  persons  who,  parti}-  for 
mone}r  and  partly  from  desire,  yield  to  our  inclinations.  I  have  also  not 
been  spared  anno}'ing  experiences  with  cheats.  Until  the  end  of  the  last 
year  (since  then,  owing  to  fear  of  venereal  infection,  I  have  not  gone 
beyond  mutual  masturbation),  I  enjo}'ed  male-love  to  the  full  extent, 
particularly  in  passive  pederasty.  I  have  never  practiced  active  peder- 
ast}r,  because  I  have  found  no  one  able  to  endure  the  pain. 

"  Generalby,  I  seek  my  lovers  among  cavalrymen  and  sailors,  and, 
eventually,  among  workmen,  especially  butchers  and  smiths.  Robust 
forms,  with  healthy  facial  complexions,  attract  me  especially.  Leathern 
riding-trousers  have  a  particular  charm  for  me.  I  have  no  partiality  for 
kissing  and  the  like.     I  also  love  large,  hard,  and  calloused  hands. 

"I  do  not  wish  to  leave  unmentioned  that,  under  certain  circum- 
stances, I  have  great  control  of  myself. 

"  As  director  of  an  estate,  I  lived  in  a  large  house.  My  personal 
servant  was  a  very  handsome  young  man  who  had  served  in  the  hussars. 
After  once  having  spoken  with  him,  in  general  terms,  on  the  subject,  and 
found  that  he  could  not  be  approached,  for  }'ears  I  lived  in  close  intimacy 
with  him,  and  enjoyed  his  beauty,  but  never  touched  him.  I  think  that, 
to  this  day,  he  knows  nothing  of  my  passion.  Likewise,  two  and  a  half 
years  ago,  in  C,  I  made  the  acquaintance  of  a  sailor,  who  is  still  regarded 


THERAPY.  337 

by  me  and  my  acquaintances  as  one  of  the  handsomest  men  we  know. 
After  an  absence  of  more  than  two  years,  on  invitation,  he  visited  me  a 
few  weeks  ago.  I  knew  how  to  arrange  matters  so  that  we  slept  in  the 
same  room,  and  I  burned  with  desire  to  be  nearer  to  him.  As  a  prelim- 
inary, however,  I  sounded  him  in  confidential  talk ;  and,  when  I  found 
that  he  despised  everything  connected  with  male-love,  I  had  not  the 
heart  to  approach  him  more  closely.  For  weeks  we  slept  in  the  same 
room,  and  I  took  constant  delight  in  his  divine  form  (at  first,  was 
sexually  excited,  in  fact) ;  I  bathed  with  him,  in  the  Roman  manner,  in 
order  to  see  his  beautiful  form  naked, — but  he  never  learned  anything  of 
my  passion.  I  still  have  an  ideal,  platonic  relation  with  this  young  man, 
who,  for  one  of  his  position,  has  an  unusual  education  and  fine  talent  for 
poetry. 

"  Until  my  thirty-eighth  year  I  had  not  a  clear  understanding 
of  my  condition.  I  always  thought  that,  by  early  and  frequent  mastur- 
bation, I  had  become  averse  to  women,  and  hoped  always  that,  when  the 
right  woman  came,  I  should  be  able  to  abandon  onanism  and  find 
pleasure  in  her.  Here  it  was  that  I  first  came  to  full}*  understand  my 
condition,  after  making  the  acquaintance  of  others  suffering  and  feeling 
like  myself.  At  first  I  was  frightened  ;  later  I  came  to  look  upon  my 
fate  as  something  not  dependent  on  myself.  Too,  I  made  no  further 
effort  to  resist  temptation. 

"  Two  or  three  weeks  ago  '  Psj'chopathia  Sexualis '  fell  into  my 
hands.  The  work  has  made  an  unexpectedly  deep  impression  on  me. 
At  first  I  read  the  work  with  an  interest  that  was  undoubtedly  lasciv- 
ious. The  description  of  the  cultivation  of  mujerados,  for  example, 
excited  me  uncommonly.  The  thought  of  a  young,  powerful  man  being 
emasculated  in  this  manner,  in  order,  later,  to  be  used  for  pederasty  by 
a  whole  tribe  of  wild,  powerful,  and  sensual  Indians,  so  excited  me  that 
I  masturbated  five  times  during  the  next  two  days,  fancj'ing  myself  such 
a  presumptive  mvjerado.  The  farther  I  read  in  the  book,  however,  the 
more  I  saw  its  moral  earnestness;  the  more  I  felt  disgust  with  my  con- 
dition ;  and  the  more  I  saw  that  I  must  do  everything,  if  it  were  possible, 
to  bring  about  a  change  in  my  condition.  When  I  had  finished  the 
book,  I  was  determined  to  seek  assistance  from  its  author. 

"  The  reading  of  this  work  had  an  undoubted  effect.  Since  then  I 
have  masturbated  only  twice,  and  have  practiced  onanism  with  cavalry- 
men only  twice.  In  every  instance  I  have  had  really  less  pleasure  and 
satisfaction  than  before,  and  I  always  have  the  feeling:  '  Ah,  if  I  could 
only  be  free  from  it!'  Nevertheless,  I  confess  that,  even  now,  in  the 
society  of  handsome  soldiers,  I  immediately  have  erection. 

"  In  conclusion,  I  may  add  that,  in  spite  of,  or,  perhaps,  on  account 

of,  onanism,  I  have  never  had  pollutions.     The  ejaculation  of  semen, 

which  usually  consists  of  only  a  few  drops,  and  it  has  always  been  so, 

takes  place  only  after  prolonged  friction.     If,  for  any  reason,  I  have  not 

22 


338  PSYCHOPATHIA    SEXUALIS. 

masturbated  for  a  long  time,  the  ejaculation  takes  place  quickly,  and  is 
more  abundant.  About  twelve  }7ears  ago  Hansen  tried  in  vain  to 
hypnotize  me." 

In  the  spring  of  1891  the  writer  of  the  foregoing  autobiography 
visited  me,  with  the  declaration  that  he  could  live  no  longer  in  his  con- 
dition ;  that  he  looked  to  hypnotic  treatment  as  the  only  hope  of  salva- 
tion, for  he  had  not  strength  enough  to  resist  his  impulse  to  masturba- 
tion and  satisfaction  with  persons  of  his  own  sex.  He  felt  like  a  pariah  ; 
like  an  unnatural  man ;  like  one  outside  the  laws  of  nature  and  society, 
and  in  danger  of  criminal  prosecution.  He  felt  moral  repugnance  when 
he  performed  the  act  with  a  man,  but  yet  the  sight  of  any  handsome 
soldier  actually  electrified  him.  For  j'ears  he  had  not  had  the  slightest 
sympathy  with  women,  not  even  mentally. 

The  patient  looked  to  be  exactly  the  person,  physically  and  mentally, 
described  by  himself  in  his  autobiography.  His  head  was  exquisitely 
hydrocephalic,  and  also  plagiocephalic.  At  first  attempts  at  hypnosis 
met  with  difficulties.  Only  by  Braid's  method,  with  the  help  of  a  little 
chloroform,  was  deep  lethargy  attained  at  the  third  sitting.  From  that 
time  simply  looking  at  a  shining  object  was  sufficient.  The  suggestions 
consisted  of  the  command  to  avoid  masturbation,  the  removal  of  homo- 
sexual feelings,  and  the  assurance  that  the  patient  would  have  inclination 
for  women  and  be  virile,  and  have  pleasure  only  in  hetero-sexual  inter- 
course. Masturbation  was  indulged  in  but  once;  after  the  eighth  sitting 
the  patient  dreamed  of  a  woman. 

When,  after  the  fourteenth  sitting,  the  patient  had  to  return,  on 
account  of  pressing  business,  he  declared  that  he  was  quite  free  from 
any  inclination  to  masturbate  or  to  indulge  in  male-love,  but  that  he  was 
by  no  means  absolutely  free  from  his  partiality  for  men.  He  felt  a 
returning  interest  in  the  female  sex,  and  hoped  to  be  freed  finally  from 
his  unhappy  condition  by  continuance  of  the  treatment. 

Case  138.  Psychical  Hermaphroditism. — Mr.  von  P.,  aged  25, 
single,  comes  of  a  neuropathic  family.  As  a  child  he  had  convulsions. 
He  recovered,  but  remained  weak,  emotional,  and  irritable.  No  severe 
illnesses.  Before  his  tenth  j'ear  sexuality  was  manifested.  His  earliest 
remembrance  concerning  it  was  that  of  lascivious  feelings  in  company 
with  the  servants  of  the  house.  When  older,  he  had  sensual  dreams 
which  were  of  intercourse  with  men.  In  circuses  the  male  performers 
alone  interested  him. 

Youthful,  powerful  men  were  most  enticing  to  him.  Often,  he 
could  scarcely  resist  the  longing  to  fall  on  their  necks  and  kiss  them. 
Of  late  simply  the  touching  of  such  persons  had  become  sufficient  to  give 
him  pleasure  and  induce  ejaculation.  The  impulse  to  engage  in  "  affairs  " 
with  men  he  had,  thus  far,  fortunately  resisted.  The  patient  is  a  psy- 
chical hermaphrodite,  in  so  far  as  he  is  not  insensitive  to  the  charms  of 
women,  and  finds  men  more  pleasing  than  women.     Iu  fact,  feminine 


THERAPY.  339 

nudity  had  never  pleased  him,  and  he  can  remember  only  to  have 
dreamed  once  of  coitus  with  a  woman. 

On  account  of  his  great  sexual  desire,  and  because  he  was  ashamed 
to  give  himself  up  to  men,  after  his  twentieth  year  he  began  to  have 
sexual  intercourse  with  women.  Since  then,  he  has  very  seldom  indulged 
in  manual  onanism,  but  often  in  mental  masturbation,  during  which  the 
forms  of  handsome  men  float  through  his  fancy. 

He  had  coitus  with  success,  but  without  pleasure  or  sensual 
feeling.  On  account  of  circumstances,  he  was  forced  to  abstain  from 
his  twenty-second  until  his  twenty-fourth  year.  This  abstinence  was 
painful,  and  he  relieved  himself,  now  and  then,  by  mental  onanism. 

When,  a  year  ago,  he  had  opportunity  again  for  coitus,  he  noticed 
failure  of  libido  for  women,  imperfect  erection;  and  premature  ejaculation. 
Finally  he  gave  up  coitus;  then  libido  for  men  was  manifested. 

In  the  condition  of  irritable  weakness  of  the  ejaculatory  centre, 
mere  touching  of  sympathetic  men  was  sufficient  to  induce  ejacula- 
tion. 

Patient  is  an  only  child.  The  circumstances  of  his  family  demand 
that  he  many.  He  justly  hesitates  to  do  this,  thinks  he  is  mentally 
impotent,  and  asks  for  advice  and  help. 

He  points  out  that  his  feeling  for  men  must  be  eradicated  in  order 
to  help  him. 

Patient's  appearance  is,  in  all  respects,  masculine.  His  head  is 
slightly  hydrocephalic  and  rhombic.  Abundant  growth  of  beard.  Geni- 
tals normal;  cremasteric  reflex  cannot  be  excited.  No  manifestations 
of  neurasthenia.  Neuropathic  eyes.  Pollutions  infrequent.  Erections 
occur  only  as  a  result  of  contact  with  men. 

Juty  16,  1889,  hypnotic  suggestion,  after  Bernheim's  method,  was 
begun.     It  was  first  at  the  third  sitting  that  deep  lethargy  was  induced. 

Suggestions :  "  You  have  no  longer  any  desire  for  men.  Only 
woman  is  beautiful  and  desirable.  You  will  love  a  woman,  marry,  be 
happy,  and  make  her  happy.  You  are  fully  potent;  you  feel  that 
already." 

In  daily  hypnosis,  which  never  goes  beyond  lethargy,  the  patient 
accepts  the  suggestions.  On  July  24th,  he  announces  that  he  has  had 
pleasure  in  coitus;  and  the  male  servants  no  longer  interest  him.  At 
the  same  time,  he  still  finds  men  more  beautiful  than  women.  On  August 
1,  1889,  it  was  necessary  to  discontinue  treatment.  Result :  Completely 
potent;  entire  indifference  for  men,  but  also  for  women. 

The  same  treatment  met  with  decided  success  in  a  case  of 
psycho-sexual  hermaphroditism,  reported  by  me  in  vol.  i  of  the 
Internal.  Centralblatt  fur  die  Physiol,  u.  Path,  der  Ham-  und 
Sexualorgane. 


340  '       PSYCHOPATHIA   SEXUALTS. 

Case  139.  Mr.  von  X.,  aged  25,  landed  proprietor.  He  comes  of  a 
neuropathic,  passionate  father.  Father  is  said  to  have  been  normal 
sexually.  His  mother  was  nervous,  as  were  her  two  sisters.  Maternal 
grandmother  was  nervous,  and  his  maternal  grandfather  was  a  roue, 
much  given  to  venery.  Patient  is  like  his  mother,  and  an  only  child. 
From  birth  he  was  weak,  suffered  much  with  migraine,  and  was  nervous. 
He  passed  through  several  illnesses.  At  fifteen  he  began  masturbation, 
without  having  been  taught  it. 

Until  his  seventeenth  year  he  says  he  never  had  feeling  for  men, 
or,  in  fact,  any  sexual  inclination  ;  but  at  this  time  desire  for  men  arose. 
He  fell  in  love  with  a  comrade.  His  friend  returned  his  love.  They 
embraced  and  kissed  and  indulged  in  mutual  onanism.  Occasionally 
patient  practiced  coitus  inter  femora  viri.  He  abhorred  pederasty.  Las- 
civious dreams  were  concerned  only  with  men.  In  the  circus  and 
theatre  males  alone  interested  him.  The  inclination  was  for  those  of 
about  twenty  years.  Handsome,  tall  forms  were  enticing  to  him.  Given 
these  conditions,  he  was  quite  indifferent  to  other  characteristics  of  the 
men.    In  his  sexual  affairs  with  men  his  part  was  alwaj's  that  of  a  man. 

After  his  eighteenth  year  the  patient  was  always  a  source  of 
anxiety  to  his  highly  respected  parents,  for  he  then  began  a  love-affair 
with  a  male  waiter,  who  fleeced  him  and  made  him  an  object  of  remark 
and  ridicule.  He  was  taken  home.  He  consorted  with  servants  and 
hostlers.  He  caused  a  scandal.  He  was  sent  away  for  travel.  In 
London  he  got  into  a  "  blackmailing  scrape,"  but  succeeded  in  escaping 
to  his  home. 

He  profited  in  no  wa}r  by  this  bitter  experience,  and  again  showed 
disgraceful  inclinations  toward  men.  Patient  was  sent  to  me  to  be  cured 
of  his  fatal  peculiarity  (December  12,  1888).  Patient  is  a  tall,  stately, 
robust,  well-nourished  young  man,  of  musculine  build  ;  large,  well-formed 
genitals.  Gait,  voice,  and  attitude  are  masculine.  He  has  no  pro- 
nounced masculine  passions.  He  smokes  but  little,  and  only  cigarettes ; 
drinks  little,  and  is  fond  of  confectioneiy.  He  loves  music,  arts, 
sesthetics,  flowers,  and  moves  in  ladies'  society  by  preference.  He  wears 
a  moustache,  the  face  being  otherwise  cleanly  shaved.  His  garments 
are  in  nowise  remarkable.  He  is  a  soft,  blase  fellow,  and  a  do-nothing. 
He  lies  abed  mornings,  and  can  scarcely  be  made  to  rise  before  noon. 
He  sa3Ts  he  has  never  regarded  his  inclination  toward  his  own  sex  as 
abnormal.  He  looks  upon  it  as  congenital ;  but,  taught  by  his  evil 
experiences,  he  wishes  to  be  cured  of  his  perversion.  He  has  little 
faith  in  his  own  will.  He  has  tried  to  help  himself,  but  always  begins  to 
masturbate.  This  he  finds  injurious,  inasmuch  as  it  causes  slight  neuras- 
thenic symptoms.  There  is  no  moral  defect.  The  intelligence  is  a  little 
below  the  average.  Careful  education  and  aristocratic  manners  are 
apparent.  The  exquisite  neuropathic  eye  betrays  the  nervous  constitu- 
tion.   The  patient  is  not  a  complete  and  hopeless  urning.    He  has  hetero- 


THERAPY.  341 

sexual  feelings,  but  his  sensual  inclinations  toward  the  opposite  sex  are 
manifested  weakly  and  infrequently.  When  nineteen,  he  was  first  taken 
to  a  brothel  by  friends.  He  experienced  no  horror  feminoe,  had  efficient 
erections,  and  some  pleasure  in  coitus,  but  not  the  instinctive  delight  he 
experienced  while  embracing  men. 

Since  then,  patient  asserts  that  he  has  had  coitus  six  times,  twice 
sica  sponte.  He  gives  the  assurance  that  he  is  always  capable  of  it,  but 
he  does  it  only  faute  de  mieux,  as  he  does  masturbation,  when  the  sexual 
impulse  troubles  him,  as  a  substitute  for  intercourse  witlr  men.  He  has 
thought  of  the  possibility  of  finding  a  sympathetic  lady  and  marrying 
her.  He  would  regard  marital  cohabitation  and  abstinence  from  inter- 
course with  men  as  hard  duties. 

Since  there  were  rudiments  of  hetero-sexual  feelings  present,  and 
the  case  could  not  be  looked  upon  as  hopeless,  it  seemed  that  treatment 
was  indicated.  The  indications  were  clear  enough,  but  there  was  no 
support  for  them  in  the  will  of  the  indolent  patient,  so  unconscious  of 
his  own  position.  It  lay  near  to  seek  support  for  the  moral  influence  in 
hypnosis.  The  fulfillment  of  this  hope  seemed  doubtful,  because  the 
famous  Hansen  had  tried  several  times,  in  vain,  to  hypnotize  him. 

At  the  same  time,  by  reason  of  the  most  important  social  interests 
of  the  patient,  it  was  necessary  to  make  another  attempt.  To  my  great 
surprise,  Bernheim's  procedure  induced  immediately  a  condition  of  deep 
lethargy,  with  possibility  of  post-hypnotic  suggestion. 

At  the  second  sitting  somnambulism  was  induced  by  merely  look- 
ing at  him.  The  patient  is  obnoxious  to  suggestions  of  all  kinds ;  indeed, 
contractures  are  induced  by  stroking  him.  He  is  awakened  by  counting 
three.  Awakened,  patient  has  amnesia  for  all  the  events  of  the  h}7pnotic 
state.  Hypnosis  is  induced  every  second  or  third  day  for  the  communi- 
cation of  hypnotic  suggestions.  At  the  same  time,  moral  and  hydro- 
therapeutic  measures  are  employed. 

The  hypnotic  suggestions  were  as  follow  : — 

1.  I  abhor  onanism,  because  it  makes  me  sick  and  miserable. 

2.  I  no  longer  have  inclination  toward  men  ;  for  love  of  men  is 
against  religion,  nature,  and  law. 

3.  I  feel  an  inclination  toward  women  ;  for  woman  is  lovely  and 
desirable,  and  created  for  man. 

During  the  sittings  the  patient  always  repeats  these  suggestions. 
After  the  fourth  sitting  it  was  noticeable  that,  when  taken  into  society, 
he  paid  court  to  ladies.  Shortly  after  that,  when  a  famous  prima-donna 
sang,  he  was  all  enthusiasm  for  her.  Some  days  later  the  patient  sought 
the  address  of  a  brothel. 

At  the  same  time,  he  preferred  the  society  of  young  gentlemen ; 
but  the  most  careful  watching  failed  to  reveal  anything  suspicious. 

February  17th.  Patient  asks  to  be  allowed  to  indulge  in  coitus,  and 
is  very  well  satisfied  with  his  experience  with  one  of  the  demi-monde. 


342  PSTCHOPATHIA   SEXUALIS. 

March  16th.  Up  to  this  time,  hypnosis  twice  a  week.  The  patient 
always  passes  into  deep  somnambulism  by  simply  being  looked  at,  and, 
at  request,  repeats  the  suggestions.  He  is  obnoxious  to  all  kinds  of 
post-hypnotic  suggestion,  and,  in  the  waking  state,  knows  not  the 
least  of  the  influences  exerted  on  him  in  the  hypnotic  state.  In  the 
hypnotic  condition  he  alwa37s  gives  the  assurance  that  he  is  free  from 
onanism  and  sexual  feeling  for  men.  Since  he  gives  the  same  answers 
in  hypnosis, — e.g.,  that  on  such  and  such  a  date  he  practiced  onanism 
for  the  last  time,  and  that  he  is  too  much  under  the  will  of  the  physician 
to  be- able  to  lie, — his  assertions  deserve  belief;  the  more,  since  he  looks 
well  and  is  free  from  all  neurasthenic  symptoms,  and,  in  the  society  of 
men,  not  the  slightest  suspicion  rests  on  him.  An  open,  free,  and  manly 
bearing  is  developed. 

Moreover,  since,  of  his  own  will,  he  now  and  then  indulges  in  coitus 
"with  pleasure,  and  occasional  pollutions  are  induced  by  lascivious  dreams 
which  concern  women,  there  can  be  no  doubt  of  the  favorable  change  of  " 
his  vita  sexualis ;  and  it  is  presumable  that  the  hypnotic  suggestions 
have  developed  into  auto-suggestive  inclinations,  which  direct  liis  feel- 
ings, thoughts,  and  will.  Probablv  the  patient  will  alwaj-s  remain  a 
natura  frigida ;  but  he  more  often  speaks  of  marriage,  and  of  his  inten- 
tion to  win  a  wife  as  soon  as  he  has  become  acquainted  with  a  Bympa- 
thetic  lady. 

In  July,  1889,  I  received  a  letter  from  his  father,  which  told  me  of 
his  good  health  and  conduct. 

On  Ma^'  24,  1890,  by  chance,  I  met  m}r  former  patient,  while  on  a 
journe}'.  His  bright,  healthful  appearance  allowed  the  most  favorable 
opinion  of  his  condition.  He  told  me  that  he  still  had  sympathetic 
feeling  for  some  men,  but  never  anything  like  love.  He  occasionally  had 
pleasurable  coitus  with  women,  and  now  thought  of  marriage. 

I  hypnotized  him,  in  the  former  manner,  to  try  him,  and  asked 
for  the  commands  I  had  given  him.  In  a  deep  condition  of  somnam- 
bulism, and  in  the  same  tone  of  voice  as  formerly,  the  patient  repeated 
the  suggestions  he  had  received  in  December,  1888, — an  excellent  example 
of  the  possible  duration  and  power  of  posthypnotic  suggestion. 

Case  140.  Psychical  Hermaphroditism ;  Improvement  with  Hypnotic 
Treatment. — Mr.  von  K.,  aged  23;  of  distinguished  family  ;  well  endowed 
mentally  ;  scrofulous  as  a  child.  His  father  is  said  to  have  been  dissi- 
pated. His  father's  brother  is  said  to  have  been  subject  to  contrary 
sexuality. 

The  patient  states  that,  when  only  seven  years  old,  he  had  a  pecu- 
liar inclination  for  male  persons.  It  was  particularly  coachmen  and 
servants  having  moustaches  for  whom  he  showed  partiality  at  that  time. 
He  experienced  a  peculiar  delightful  sensation  when  he  pressed  him- 
self against  such  persons. 

The  patient  entered  the  cadet  corps  early,  and  there  he  was  seduced 


THERAPY.  343 

Into  mutual  onanism,  and  also  learned  imitatio  coitus  inter  femora  viri. 
At  the  age  of  seventeen  he  had  coitus  with  a  prostitute  for  the  first 
time.  He  performed  the  act  perfectly,  hut  had  not  the  slightest  pleasure 
in  it ;  and  he  learned  that  this  kind  of  gratification  amounted  to  nothing, 
or  that  he  must  he  different  from  other  }'oung  men. 

Nevertheless,  he  often  had  coitus,  and  contracted  gonorrhoea. 
After  this  he  experienced  an  increasing  aversion  for  the  female  sex,  and 
indulged  in  coitus  less  and  less  frequently ;  in  fact,  only  when,  with 
intense  libido,  he  could  not  gain  opportunity  for  intercourse  with  men. 
His  inclination  for  men  predominated  more  and  more,  and  he  was 
attracted  exclusively  by  those  handsomely  formed,  and  having  as  little 
beard  as  possible.  He  descended  to  the  most  revolting  practices, — 
coitus  buccalis,  active  and  passive  pederasty. 

The  patient  was  deeply  ashamed  of  such  depravity,  and  was  con- 
stantly endeavoring  to  get  into  better  ways  by  means  of  coitus  with 
women.  But  he  came  to  the  despairing  conclusion  that  his  moral 
strength  was  insufficient,  that  he  was  indifferent  about  intercourse  with 
women,  or  that  it  was  repugnant  to  him;  and  that  he  was  created  for 
sexual  intercourse  with  persons  of  his  own  sex.  In  fact,  he  had  never 
dreamed  of  women,  but  always  of  men  ;  and  that  at  a  time,  too,  when  he 
had  no  suspicion  of  the  difference  between  the  sexes. 

The  patient  comes  for  consultation,  because  he  sees  that  he  is 
jeopardizing  the  happiness  of  his  whole  life,  and  recognizes  the  unnatu- 
ralness  and  immorality  of  his  sexual  life.  He  does  not  regard  his  con- 
dition as  hopeless ;  for  he  has  no  horror  of  women,  and  three  weeks  ago 
he  had  successful  coitus  with  one,  though  it  was  devoid  of  all  pleasure 
and  mental  satisfaction.  He  has  no  doubt  that  he  was  really  created  to 
love  men  ;  but,  owing  to  acquired  neurasthenia,  in  the  sexual  act  with  a 
man  he  experiences  no  such  pleasure  as  formerly.  He  had  given  up  his 
position  as  an  officer,  because  the  soldiers  excited  him  so  sexually  that 
he  feared  he  might  compromise  himself. 

The  patient  is  devoid  of  degenerative  signs.  His  appearance  is 
perfectly  masculine,  and  his  genitals  are  normal.  Examination  of  the 
semen  revealed  abundance  of  spermatozoa.  The  penis  is  large  and  well 
developed  ;  the  growth  of  hair  ad  genitalia,  as  well  as  on  the  rest  of  the 
body,  is  abundant.  The  patient  has  masculine  tastes,  but  has  never  been 
partial  to  drinking  and  smoking.  A  neuropathic  eye  is  all  that  points 
to  a  nervous  constitution. 

In  his  sexual  acts  with  men,  he  states  that,  as  a  rule,  he  has  felt  as 
a  man,  only  now  and  then  as  a  woman. 

An  attempt  at  hypnosis  leads  to  letharg}',  with  cataleptic  condition 
of  the  muscles,  and  the  opportunity  is  used  to  impart  suitable  suggestions. 

After  the  fourth  sitting  he  expressed  himself  as  satisfied,  and 
wondered  that  men  made  no  impi-ession  on  him.  He  wished  to  try  his 
fortune  with  women,  but  was  afraid  that  he  was  impotent. 


344  t>SYCHOPATHIA  SEXUALIS. 

After  the  sixth  sitting,  without  advice,  he  attempted  coitus  cum 
muliere.  His  libido  was  very  great,  but  inter  actum  this  and  erection 
left  him. 

After  the  ninth  sitting  the  patient  was  forced  to  discontinue  treat- 
ment, owing  to  business  that  called  him  home.  He  was  satisfied,  in  that 
he  felt  indifferent  and  capable  of  resistance  to  men.  He  felt  sure  that 
he  would  not  relapse  into  his  former  vices.  At  the  same  time,  he  had 
not  the  slightest  interest  in  the  female  sex. 

Case  141.  Mr.  X.,  aged  31,  chemist,  comes  of  a  neuropathic  family, 
and  from  childhood  has  been  nervous,  emotional,  and  apprehensive,  and 
afflicted  with  migraine.  He  remembers  distinctly  that,  when  a  very 
small  boy,  he  had  a  lustful  feeling  at  the  sight  of  the  half-naked  persons 
in  the  work-shop  at  his  father's  house,  and  felt  drawn  to  them.  When 
he  began  school,  he  felt  in  the  same  way  toward  his  companions.  At  the 
age  of  eleven,  without  teaching,  he  began  to  masturbate,  during  which 
he  thought  of  his  comrades.  Later  there  were  enthusiastic  friendships. 
His  vita  sexualis  gained  the  upper  hand.  As  he  grew  up,  women  also 
interested  him,  but  his  chief  interest  was  in  men  of  the  higher  circles  of 
society.  He  felt  that  this  inclination  was  abnormal,  and  sought  the 
acquaintance  of  puellis ;  he  often  had  coitus,  but  never  with  any  real 
pleasure.  Thus  he  became  more  and  more  given  to  contrary  sexuality, 
practiced  mutual  masturbation  and  coitus  inter  femora  viri,  and  occasion- 
ally gave  himself  up  to  passive  pederasty ;  but  he  soon  abandoned  this, 
on  account  of  the  pain  it  caused  him. 

He  asserts  that  he  feels  perfectly  masculine,  and  has  never  had 
female  inclinations.  Skeleton  and  attitude  perfectly  masculine  ;  strabis- 
mus ;  abundant  beard ;  genitals  entirely  normal.  No  aversion  to  the 
female  sex.  Occasional  coitus  with  puellis,  but  without  satisfaction. 
The  patient  feels  exceedingly  unhappy,  and  clearly  recognizes  his  abnor- 
mal position  ;  at  any  price,  he  wishes  to  be  freed  from  his  homo-sexual 
inclination,  and  made  capable  of  marriage.  "  It  is  terrible  to  have  to 
act  a  farce  constantly."  At  the  first  attempt  at  hypnosis,  after  Bern- 
heim's  method,  the  patient  passes  into  a  state  of  deep  lethargy.  He 
proves  to  be  very  susceptible  to  suggestion,  and  suitable  suggestions  are 
imparted.  After  the  fourth  sitting,  he  states,  with  gratitude,  that  men 
become  indifferent,  and  he  begins  to  have  pleasure  in  coitus ;  but  he  did 
not  feel  mentally  satisfied,  owing  to  the  fact  that  he  was  limited  to 
puellae  publicae.  After  the  fourteenth  sitting  he  declared  that  he  re- 
quired no  more  treatment.  He  was  in  love  with  a  young  lady,  and 
thought  of  marrying  her.  He  asked  for  her  hand,  and  was  refused. 
Soon  after,  while  he  was  on  a  journe}'  in  Italy,  men  interested  him  again. 
He  had  a  relapse,  and  asked  for  further  treatment.  A  few  sittings  re- 
established the  status  quo  ante. 

Case  142.  Psychical  Hermaphroditism;  Successful  Treatment  by 
Hypnotic  Suggestion. — Mr.  von  Z.,  aged  29.     He  asserts  that  he  comes 


THERAPY.  345 

of  healthy  grandparents  ;  of  a  healthy  father,  hut  of  a  nervous  mother. 
He  is  an  only  child,  and  was  petted  bjr  his  mother.  At  the  age  of  eight 
he  was  powerfully  excited  sexually  by  a  male  servant,  who  showed  him 
pornographic  pictures  and  his  penis. 

When  twelve  years  old,  Z.  fell  in  love  with  his  tutor.  On  going  to 
sleep,  the  naked  form  of  this  man  appeared  before  him.  He  thought  of 
himself  as  in  a  female  role  in  relation  to  him,  and  thought  to  marry  him 
some  time. 

At  the  age  of  thirteen,  at  a  private  ball,  his  fancy  was  excited  by  a 
young  governess,  and,  at  fifteen,  he  fell  in  love  with  a  young  lady.  He 
remained  very  excitable  sensually  ;  but,  thereafter,  exclusively  so  to  men 
pleasing  to  him.     Masturbation  was  not  practiced. 

At  the  age  of  twenty  the  patient  became  neurasthenic  (ex  absti- 
nentia?).  He  now  attempted  coitus,  but  was  not  successful.  On  the 
other  hand,  he  had  intense  desire  on  an  occasion  when  he  saw  a  naked 
man  in  a  steam-bath.  The  latter  noticed  his  excitement,  approached 
him,  and  performed  masturbation  on  him,  giving  the  patient  intense 
delight.  He  felt  powerfully  attracted  to  this  man,  and,  thereafter, 
allowed  him  to  repeat  the  act.  In  the  meantime,  there  were  attempts  at 
coitus  with  females,  which  always  ended  in  a  fiasco.  The  patient  was 
much  troubled  by  this,  and  consulted  physicians,  who  explained  his  im- 
potence as  due  to  nervousness,  and  thought  that  it  would  soon  pass  off. 

Until  his  twenty-fifth  year  his  sexual  indulgence  consisted  of  mas- 
turbation by  the  beloved  man  about  once  a  month.  At  this  time  he  last 
felt  attracted  to  a  woman.  It  was  to  a  young  peasant-girl.  She  would 
not  accede  to  his  wishes.  Since  his  lover  was  also  unattainable,  the  pa- 
tient began  to  masturbate  alone.  With  this,  his  neurasthenia  increased. 
For  this  reason  he  was  unable  to  finish  his  studies;  he  became  shy, 
dysthymic,  abulic,  and  now  vainly  tried  cures  at  various  hydropathic 
establishments.  On  account  of  continued  severe  (cerebro-spinal)  neu- 
rasthenia, the  patient  came  to  me  for  advice,  in  the  latter  part  of 
February,  1890 

A  tall,  slim  man,  of  aristocratic  and  decidedly  masculine  manners. 
Neuropathic  appearance ;  large  ears,  the  lobes  of  which  run  into  and  lose 
themselves  in  the  skin  of  the  cheeks.  Genitals  perfectly  normal.  The 
usual  picture  of  cerebro-spinal  neurasthenia  of  moderate  degree.  Great 
depression ;  complaint  of  being  dissatisfied  with  life,  even  to  tsedium 
vitae ;  he  is  pained  by  his  sexual  anomaly,  especially  because  he  is  urged 
by  his  family  to  marry. 

He  is  interested  in  women  only  mentally,  not  physically.  Sexually, 
his  only  interest  is  in  men  of  distinction.  His  dreams  have  never  been 
about  persons  of  the  opposite  sex,  but  of  those  of  his  own  sex.  In  these 
lascivious  dreams  he  has  always  seen  himself  in  the  role  of  a  woman. 

The  most  refined  woman  has  never  been  able  to  induce  erection  or 
even  libido  in  him. 


346  PSYCfiOPATHtA   SEXUALIS. 

His  sexual  intercourse  with  men  has  consisted  of  passive  or  mutual 
masturbation.  He  had  practiced  solitary  onanism  only  infrequently  and 
faute  de  mieux.  During  the  last  five  months  he  had  abstained,  and  had 
had  no  male  intercourse  since  August,  1889. 

An  attempt  at  hypnosis," after  Bernheim's  method,  failed ;  prolonged 
stroking  of  the  brow  induced  deep  lethargy,  with  catalepsy. 

This  method  is  used,  in  order  to  carry  out  suggestive  treatment  of 
this  patient,  who  is  so  worthy  of  compassion.  The  hypnotic  state  is 
alwa}rs  the  same ;  he  cannot  be  brought  into  a  state  of  somnambulism. 

At  the  third  sitting  the  patient  is  given  the  suggestions  :  ever  de- 
spise onanism  and  male  love ;  find  women  beautiful,  and  dream  of  them. 

After  the  sixth  sitting  (March  10th)  a  moral  transformation  takes 
place  in  his  mind.  The  patient  becomes  quieter,  feels  more  free,  and 
dreams  now  and  then  of  women,  and  no  longer  of  men,  finding  that  the 
latter  have  become  indifferent  to  him.  He  gratefully  states  that  he  has 
no  more  inclination  to  masturbation.  He  approaches  women,  but  he 
notices  that  they  have  not  the  least  attraction  for  him. 

On  March  19th,  business  called  the  patient  home ;  so  that  the  treat- 
ment had  to  be  discontinued. 

On  May  11,  1890,  the  patient  returned  for  treatment.  He  asserted 
that  he  had  not  masturbated  in  the  interval,  and  that  he  had  resisted  his 
inclination  to  men.  Too,  he  had  not  dreamed  of  men,  but  twice  of 
women,  though  only  platonically.  His  cerebral  asthenia  (ex  abstinentia  ?) 
had  increased.  He  apparently  suffers  for  the  want  of  mental  and  sensual 
satisfaction  of  his  vita  sexualis ;  for  homo-sexual  love  and  masturbation 
have  become  impossible  for  him,  and  intercourse  with  women  is  denied 
him.  The  patient  is  thus  painfully  depressed  to  the  extent  of  taedium 
vitas. 

He  is  now  subjected  to  anti-neurasthenic  treatment  (hydro-thera- 
peutic and  electro-therapeutic),  and  the  treatment  by  hypnosis  is  re- 
sumed. Only  after  ten  weeks  of  painstaking  treatment  did  the  neuras- 
thenic symptoms  disappear.  Progressing  parallel  with  this,  there  was 
a  change  of  his  mental  personaltty. 

The  patient  was  gratified  to  note  that  he  grew  stronger ;  that  his 
sexual  life  no  longer  played  a  dominating  part.  Though  he  felt  more 
drawn  toward  men  than  women,  yet  he  easily  resisted  homo-sexual 
desires.  His  former  boudoir  became  a  work-room ;  instead  of  to  adorn- 
ment and  frivolous  reading,  he  gave  himself  to  walks  in  the  mountains 
and  forests.  On  account  of  the  danger  of  a  fiasco,  the  initiative  in 
hetero-sexual  attempts  was  left  to  the  patient. 

It  was  not  until  the  fourteenth  week  of  treatment  that  the  patient 
made  an  attempt.  It  was  perfectly  successful.  The  patient  became 
happy,  and  sound  in  body  and  mind,  and  expressed  the  best  hope  of  his 
future,  even  having  thoughts  of  marriage. 

He  experienced  increasing  pleasure  in  normal  sexual  intercourse ; 


THERAPY.  347 

he  occasionally  had  lascivious  dreams  of  women,  and  no  longer  dreamed 
of  men. 

.  The  patient  stopped  treatment  at  the  end  of  September.  He  felt 
perfectly  normal  in  hetero-sexual  intercourse,  devoid  of  neurasthenia,  and 
had  thoughts  of  marriage.  Yet  he  freely  confessed  that  he  still  always 
had  erections  at  the  sight  of  a  naked,  handsome  man ;  though  he  could 
easily  resist  the  desires  that  arose,  and  in  dreams  had  exclusively  "  rela- 
tions avec  la  femme." 

In  April,  1891,  I  again  saw  the  patient,  and  he  was  in  the  best  of 
health.  He  regarded  his  vita  sexualis  as  perfectly  normal ;  for  he  had 
coitus  regularly  with  pleasure  and  full  virility,  dreamed  only  of  women, 
and  had  no  inclination  to  masturbation.  Yet  he  made  the  interesting 
confession  that  frequently,  post  coitum,  he  still  had  a  temporary  "  gout 
pour  Vhomme"  which  he  could  easily  control.  He  thought  he  was  last- 
ingly cured,  and  was  occupied  with  thoughts  of  marriage. 

Case  143.  Congenital  Contrary  Sexual  Feeling.  Successful  Re- 
moval of  Homo-Sexual  Feelings  by  Suggestions. — L.,  doctor  of  philoso- 
phy, aged  34,  German,  consulted  me,  in  the  spring  of  1888,  on  account 
of  perversion  of  his  vita  sexualis,  and  asked  whether  he  could  not  be 
freed  from  it  by  means  of  hypnotic  treatment. 

Patient  came  of  a  healthy  mother,  in  whose  family,  for  genera- 
tions, there  had  been  neither  insanity  nor  nervous  disease.  He,  like 
his  only  brother,  is  much  like  his  father  mentally.  His  brother  is  very 
sensual,  and  also  psychically  abnormal,  and  given  to  over-indulgence  in 
drink. 

His  father  was  a  neuropathic,  eccentric  man.  Nothing  is  known 
of  any  abnormal  sexual  manifestations  in  him,  though,  like  all  his 
brothers,  he  had  a  tendency  to  over-indulgence  in  alcohol. 

This  vice  seems  to  have  been  inherited  from  his  mother  (grand- 
mother of  patient),  who  was  a  notorious  drinker.  The  father  of  this 
woman  (great-grandfather  of  patient)  was  also  a  great  drinker.  No  other 
ancestral  history  was  obtainable. 

Patient  states  that  from  childhood  he  was  nervous  and  easily  ex- 
cited. He  learned  very  easily,  and  had  a  talent  for  languages.  He  was 
always  interested  in  art,  particularly  in  music  and  poetry.  His  education 
was  excellent,  and  given  at  home.  When  he  was  thirteen,  his  father  told 
him  that  he  should  never  touch  his  genitals,  for  it  was  wrong  to  do  so, 
and  to  do  it  might  bring  unhappiness. 

Occasionally  his  father  showed  him  pictures  of  syphilitic  diseased 
conditions,  etc.,  in  an  anatomical  museum,  and  the  patient  was  disgusted 
and  frightened.  He  believed  that  his  later  fear  of  sexual  intercourse 
with  women  was  partly  nourished  by  this  early  erroneous  teaching. 

However,  the  patient  seeks  the  principal  cause  of  his  sexual  per- 
version in  a  defect  of  organization.  When  a  small  boy,  he  had  a  silly  en- 
thusiasm for  companions.     He  also  remembers  that,  at  that  time,  he  had  a 


348  PSYCHOPATHIA   SEXUALlS. 

desire  only  for  girlish  games,  and  preferred  the  society  of  girls.  When 
a  boy,  he  had  a  passion  for  crocheting  and  embroidering.  At  fourteen  he 
was  still  without  an}'  sexual  knowledge,  and  fell  into  the  hancjs  of  a 
pederast.  He  ran  away,  frightened,  when  he  learned  what  was  to  be  done 
with  him.  When  fifteen,  a  sympathetic  companion  was  accustomed  to  lay 
his  head  in  the  patient's  lap.  This  gave  the  patient  a  peculiar  pleasurable 
feeling,  but  he  knew  no  explanation  of  it.  At  sixteen  he  had  the  first 
erections — at  the  sight  of  men. 

At  twenty  he  first  learned  that  his  sexual  condition  was  perverse, 
and  recognized  the  fact  that  what  he  had  taken  for  friendship  was  love. 
He  was  much  frightened  at  the  discovery,  and  much  pained.  His  sympa- 
thies were  directed  toward  young  men  of  the  upper  class  that  were 
handsomely  formed  and  of  pleasing  appearance. 

The  society  of  ladies  had  no  effect  on  him.  He  was  never  attracted 
by  the  charms  of  the  opposite  sex.  In  his  fifteenth  year  he  had  a  sensual 
dream,  in  which  he  thought  a  girl  of  elegant  figure  sat  opposite  him,  on 
a  sofa. 

In  the  theatre  it  was  only  the  art  of  the  actresses  that  he  admired ; 
the  actors  excited  his  real  interest. 

Drinking  and  smoking  had  always  been  very  repugnant  to  him. 
Hunting  and  gymnastics,  and  other  masculine  occupations,  had  no 
interest  for  him.  He  did  not  enter  the  army,  because  his  general  physical 
weakness  precluded  it. 

The  patient  has  but  little  sexual  desire.  He  has  never  had  any  im- 
pulse to  satisfy  himself  with  persons  of  his  own  sex.  Some  3-ears  ago, 
when  he  first  tried  to  embrace  a  man  lovingly,  he  had  powerful  erection  and 
became  greatly  excited ;  but  he  was  able  to  control  himself  and  to  repel 
his  lover.  Thereafter  he  always  avoided  such  attempts.  It  was  only 
seldom  that  he  became  powerfully  excited  sexually,  and  even  then  he  was 
not  driven  to  satisfy  himself.  He  was  never  given  to  onanism.  During 
the  establishment  of  puberty,  the  patient  had  frequent  dreams  with  pol- 
lutions, but  these  were  not  induced  by  erotic  fancies  of  any  kind. 

Some  years  ago,  for  a  long  time,  ejaculation  was  alwaj'S  induced  by 
the  embrace  of  a  sympathetic  man,  but  this  condition  of  irritable  weak- 
ness disappeared.  As  j^ears  passed,  the  patient,  who  had  always  had  a 
desire  for  marriage  and  a  family,  became  anxious  on  account  of  the  con- 
viction that  the  inclination  toward  females,  for  which  he  had  hoped, 
would  never  come.  It  became  more  and  more  clear  to  him  that  he  was 
abnormal,  and  he  began  to  have  fears  about  his  virilit}7  and  his  future 
happiness  in  life. 

In  order  to  test  the  matter,  he  sought  a  brothel.  He  found  a  pros- 
titute of  beautiful  form ;  he  had  the  best  will  to  satisfy  himself  that  he 
was  virile ;  the  woman  did  all  she  could,  but  in  vain.  There  was  no 
erection,  and  he  withdrew,  ashamed.  New  attempts,  under  the  most 
favorable    circumstances,  were    likewise    failures,  though    the    patient 


THERAPY.  349 

brought  his  imagination  to  his  aid,  and  thought  himself  to  be  embracing 
a  man  instead  of  a  woman. 

He  now  realized  that  his  ideal — to  consummate  marriage — was 
impossible.  He  felt  himself  very  unfortunate,  and  dissatisfied  with  life. 
Besides,  it  forced  itself  upon  him  that  morally  he  was  lowered,  because 
he  could  not  overcome  his  incbnation  for  his  own  sex,  and  his  friendship 
for  respectable  men  of  his  circle  was  degraded  by  sexual  feelings.  In 
his  consultation  with  me,  the  patient  was  unending  in  the  description  of 
his  painful  situation.  His  ideal  was  marriage.  He  longed  for  4t,  for 
purely  ethical  reasons.  He  thought  of  it  as  something  holy;  but  the 
begetting  of  children,  the  sexual  act,  was  very  repugnant  to  him.  At 
the  same  time,  he  saw  that  he  could  not  really  marry  without  being 
potent.  Would  not  hypnotic  suggestion  exercise  a  favorable  influence 
on  his  sexual  life  ?  He  had  not  the  energy  of  a  man  of  normal  sexual 
condition.  He  seemed  to  himself  to  be  all  wrong.  He  would  endure  all — 
to  be  poor  and  miserable — if  he  could  but  have  a  normal  sexual  inclination. 

When  the  patient  was  gently  told  of  the  congenital  and  deep  con- 
stitutional significance  of  his  sexual  anomaly,  and  shown  that,  therefore, 
the  creation  of  a  normal  sexual  condition  was  doubtful,  he  thought  that 
he  would  be  satisfied  to  remain  in  his  condition.  But  he  wished  to  know 
whether  it  were  not  possible  to  eradicate  his  inclination  for  men,  without 
attempting  to  create  an  equivalent  for  women  ;  and  if,  in  hypnosis,  it  could 
not  be  suggested  to  him  that,  in  the  future,  men  be  a  matter  of  indifference 
to  him,  and  that,  in  intercourse  with  his  friends,  he  no  longer  be  excited 
sexually.  Such"  a  result  would  elevate  very  much  his  moral  feeling,  and 
make  him  satisfied  and  unembarrassed  in  social  relations  with  his  friends. 

The  possibility  of  such  suggestive  removal  of  feelings  by  hypnosis 
could  not  be  gainsaid,  though  he  was  in  doubt  as  to  whether  he  could  be 
hypnotized  or  not,  since  the  hypnoscope  had  proved  to  have  no  effect 
upon  him. 

Out  of  pity  and  scientific  interest,  I  decided  to  make  an  immediate 
attempt  at  hypnosis,  after  Bernheim's  method. 

The  patient  passed  easily  into  a  condition  of  deep  lethargy,  and,  in 
a  drawling  voice,  repeated  the  following  suggestion :  "  I  feel  that,  from 
this  time,  I  am  sexually  indifferent  to  men ;  and,  that  a  man  is  as  sexually 
indifferent  to  me  as  a  woman." 

When  I  counted  three, — having  suggested  previously  that  he  awake 
at  three, — the  patient  came  to  himself,  as  if  out  of  a  deep  sleep,  and  per- 
formed immediately  the  post-hypnotic  suggestion  to  open  the  door  of 
the  stove.  He  said  that  he  had  not  lost  consciousness  entirely,  that  he 
had  felt  as  one  paralyzed  and  without  will,  and  that  he  had  felt  a 
peculiar  creeping  sensation  in  all  his  limbs. 

After  five  days  the  patient  came  again.  In  manner  he  was  a 
different  person,  and  he  said,  joyfully,  that  he  felt  like  another  man. 
Energy  and  will-power — the  loss  of  which  he  had  felt  so  keenly — had 


350  PSYCHOPATHIA   SEXUALIS. 

returned.  He  felt,  now,  entirely  unembarrassed  toward  men,  and  had  a 
new  joy  in  living. 

The  following  seven  days  he  was  hypnotized.  Hypnosis  is  no 
longer  as  deep  as  at  first,  though  the  suggestion  is  always  accepted  and 
repeated.  However,  he  is  quite  profoundly  influenced ;  for,  the  sugges- 
tion given,  he  sleeps  on,  in  a  state  of  lethargy,  for  ten  minutes,  and  has 
to  be  awakened  by  suggestion.  This  always  occurs  as  if  from  a  deep 
sleep, — slowly,  and  through  a  stage  of  somnolence. 

After  the  eighth  sitting  the  patient  found  himself  well  and  happy, 
and  in  possession  of  full  self-confidence.  He  had  the  feeling  and  the 
evidence  that  men  had  no  influence  on  him. 

He  thought  he  could  dispense  with  hypnotic  treatment,  and  grate- 
fully took  his  leave,  with  the  promise  that,  should  the  influence  of  the 
suggestion  fade,  he  would  come  again.  Since  then,  I  have  heard  nothing 
more  of  this  interesting  patient,  and  I  have  reason  to  hope  that  he 
remains  improved. 

The  patient  is,  in  all  respects,  of  masculine  appearance;  beard 
abundant.  Physically,  with  the  exception  of  slight  neurasthenic  symp- 
toms, he  presents  nothing  remarkable.  Genitals  normal.  (Personal  case. 
Internat.  Centralblatt,  etc.,  Bd.  i,  Heft  1.) 

Case  144.  X.,  aged  33;  single;  tall.  Mentally,  of  small  endow- 
ment ;  comes  of  tainted  family.  Paternal  grandfather  died  at  thirty -four 
with  a  mental  disease,  which  is  said  to  have  developed  as  a  result  of 
onanism  and  spermatorrhoea.  His  father  and  brother  suffered  with  dis- 
turbances of  the  sexual  functions.  There  was  insanity  in  the  mother's 
family ;  other  branches  of  the  family  were  noted  for  their  irritable  and 
eccentric  character. 

The  patient  has  too  small  a  head,  a  retreating  brow,  abnormal  ears, 
sparse  growth  of  hair,  and  a  hernia,  which  is  probably  congenital. 
Genitals  large,  and  normally  developed. 

Great  impressionability ;  neuropathic  constitution  ;  occasional  tae- 
dium  vitse.  For  several  years,  peculiar,  imperative  ideas :  that  he  is  a 
locomotive ;  a  horse ;  a  velocipede ;  and,  that  he  must  act  accordingly. 
From  his  earliest  youth,  contrary  sexual  feeling  (congenital).  Horror 
feminae ;  sexual  inclination  toward  boys  ;  satisfaction  by  sensual  contact, 
and,  faute  de  mieux,  masturbation.  One  day  he  had  an  affair  with  a 
boy  dressed  in  gray,  which  made  a  deep  impression  on  him.  Since  then, 
while  masturbating,  the  image  of  the  boy  comes  into  his  mind ;  and  he 
cannot  see  gray  clothes  without  having  powerful  erections.  On  the 
advice  of  phj^sicians  whom  he  consulted,  he  attempted  coitus  with 
women,  but  was  cold  and  impotent,  notwithstanding  the  assistance  of 
memory -pictures  of  the  boy  dressed  in  gray ;  and  he  finally  gave  up  the 
efforts. 

March  27th,  first  hypnotic  sitting.  Small  result.  He  resists,  and 
says  his  fancy  keeps  him  from  going  to  sleep. 


THERAPY.  351 

In  a  further  series  of  sittings  he  declares  that  he  experiences  un- 
favorable effects, — is  more  excited,  and  troubled  by  imperative  ideas  and 
the  desire  to  masturbate.  He  makes  fun  of  the  physician  and  hypnotism, 
and  offers  much  resistance,  with  the  expression  that  hypnotism  is  good 
for  nothing,  and  only  makes  people  crazy. 

However,  gradually  it  became  possible  to  induce  somnambulism. 
After  twenty-five  sittings  the  patient  confessed  that  he  was  better,  and 
that  he  .was  less  troubled  with  imperative  ideas  and  onanism.  The  sit- 
tings were  repeated  every  week  or  two.  The  patient  felt  mentally  and 
morally  well,  ceased  to  masturbate,  but,  at  the  end  of  treatment,  was  in- 
different toward  the  opposite  sex  (Dr.  Ladame,  Bevue  de  Vhyp?iotisme, 
September  1,  1889). 

In  the  two  foregoing  cases  there  was  successful  suggestive 
removal  of  homo-sexual  feelings, — a  result  which,  as  Case  143 
shows,  means  a  great  improvement  for  such  unfortunate  indi- 
viduals, in  that  it  protects  them  from  shame  and  the  law.  An 
entirely  different  and  phenomenal  result  is  presented  by  the 
following  case,  reported  by  Dr.  v.  Schrenk-Notzing  in  the 
Wiener  internal.  Jclin.  Rundschau,  October  6,  1889,  No.  40, 
which  is  a  case  of  effemination.  It  discloses  a  new  method 
of  treatment  of  urnings;  but  it  is  necessary  to  guard  against 
illusions.  Only  where  hypnosis  can  be  deepened  to  somnam- 
bulism, are  decided  and  lasting  results  to  be  expected: — 

Case  145.  Congenital  Contrary  Sexual  Instinct  Improved  by 
Hypnotic  Suggestion. — R.,  official,  aged  28.  January  20,  1888,  he  sought 
medical  advice.  He  is  the  brother  of  the  patient  who  is  the  subject  of 
Case  135,  and,  therefore,  of  a  badly  tainted  family  (v.  supra).  Toward  the 
end  of  treatment,  he  confessed  that  he  was  the  author  of  the  autobiography 
which  was  published  as  Case  83  in  the  fifth  edition  of  this  work,  and  it 
is  here  reproduced  : — 

"  In  brief,  my  abnormality  consists  of  this,  that  in  sexual  relations  I 
feel  myself  to  be  completely  feminine.  Since  my  earliest  youth,  in  my 
sexual  acts  and  fancies,  I  have  always  had  before  my  eyes  only  images 
of  masculine  beings  and  masculine  genitals. 

"  Until  I  went  to  the  University,  I  found  nothing  in  this  (I  had  never 
spoken  with  others  about  my  fancies,  but  rather,  while  at  the  Gymnasium, 
lived  a  silent  and  retired  life). 

u  While  at  the  University,  it  struck  me  that  female  persons  made  not 
the  slightest  impression  on  me.  Since  then,  in  houses  of  prostitution, 
etc.,  I  have  attempted  coitus,  or  only  to  obtain  an  erection,  with  women, 
but  always  in  vain. 


352  PSYCHOPATHIA    SEXUALIS. 

"  Erection  ceased  immediately,  as  soon  as  I  was  in  a  room  alone  with 
a  woman.  At  first  I  considered  it  impotence,  though,  at  the  same  time,  I 
was  so  excited  sexually  that  I  had  to  masturbate  several  times  during  the 
day  in  order  to  sleep. 

"  Quite  different,  however,  has  been  the  development  of  my  feel- 
ings toward  the  masculine  sex,  and  it  has  grown  stronger  every  year. 
At  first  they  expressed  themselves  in  extraordinary,  enthusiastic  friend- 
ship for  certain  persons,  under  whose  windows  at  night  I  would  wait 
for  hours ;  whom  in  all  possible  ways  I  would  try  to  meet  on  the  streets, 
and  with  whom  I  sought  to  come  in  contact.  I  wrote  such  persons 
the  most  passionate  letters,  in  which,  however,  I  was  shy  in  express- 
ing my  feelings  too  plainly.  Later,  after  my  twentieth  year,  I  came 
to  understand  the  essential  nature  of  my  inclinations,  particularly  from 
the  sensual  pleasure  I  experienced  as  soon  as  I  came  in  direct  contact 
with  any  of  these  friends.  These  persons  were  all  finely  built  men, 
with  dark  hair  and  eyes.  I  have  never  had  my  feelings  excited  by  boys. 
Real  pederasty  is  absolutely  incomprehensible  to  me.  About  this  time 
(twenty-second  to  twenty-third  year)  the  circle  of  my  beloved  friends 
grew  more  and  more  extensive.  Now  I  can  scarcely  see  a  handsome  man 
on  the  street  without  having  the  wish  to  possess  him  excited  in  me.  The 
fact  is,  I  especially  love  persons  of  the  lower  classes,  whose  powerful 
forms  attract  me, — soldiers,  policemen,  car-drivers,  etc., — i.e.,  all  that  wear 
uniforms.  If  one  of  these  returns  my  look,  I  feel  a  kind  of  thrill  go 
through  my  whole  body.  I  am  especially  excitable  in  the  evening,  and 
merely  the  heavy  tread  of  a  soldier  is  alone  sufficient  to  induce  the 
most  powerful  erections.  I  take  a  very  peculiar  pleasure  in  following 
such  persons  and  looking  at  them.  As  soon  as  I  learn  that  they  are 
married,  or  that  they  consort  with  girls,  my  excitement  very  frequently 
ceases. 

"  A  few  months  ago  I  became  able  to  control  my  inclinations  to 
such  an  extent  that  they  were  not  directly  noticeable.  About  this  time  I 
followed  a  soldier  who  seemed  likely  to  acquiesce  in  my  desire,  and  spoke 
to  him.  For  money  he  was  ready  for  anything.  At  once  I  was  filled 
with  a  most  violent  longing  to  embrace  and  kiss  him,  and  the  danger  of 
being  noticed  did  not  deter  me  from  doing  it.  He  had  scarcely  grasped 
my  genitals  when  ejaculation  followed.  With  this  meeting,  I  had  finally 
attained  the  long-desired  goal  of  my  life.  I  knew  that  my  whole  nature 
would  find  its  happiness  and  satisfaction  in  it,  and  from  this  time  I  gave 
myself  up  entirely  to  the  effort  to  find  a  person  whom  I  could  love,  and 
from  whom  I  should  never  part.  For  my  acts  I  do  not  experience  the 
slightest  twinge  of  conscience. 

"  To  be  sure,  in  quiet  moments,  I  very  well  appreciate  the  difference 
between  my  way  of  thinking  and  the  way  of  the  world  ;  as  a  lawyer,  too, 
I  naturally  recognize  the  dangers  of  a  relation  of  the  kind  I  desire; 
but,  as  long  as  my  entire  nature  does  not  change,  I  shall  not  be  able  to 


THERAPY.  353 

give  up  the  opportunities  offered  me.  Nevertheless,  I  should  be  willing 
to  undergo  any  cure  to  be  freed  from  my  abnormal  condition. 

"  I  recognize  my  feminine  feeling,  among  other  things,  in  the  fact 
that  any  sensual  idea  in  connection  with  a  woman  must  be  forced,  and 
seems  unnatural  to  me.  I  am  also  sure  that  my  respect  for  a  woman — 
I  move  much  in  the  society  of  ladies,  and  enjoy  it — would  change  imme- 
diately to  repugnance,  were  I  to  notice  any  sensual  inclination  in  her 
toward  me.  In  my  dreams  and  sensual  fancies  of  men,  I  always  think 
of  myself  in  such  positions  with  them  that  their  faces  are  always  toward 
mine.  My  greatest  delight  would  be  to  have  a  powerful  man,  undressed, 
take  me  in  his  arms  with  a  force  I  could  not  resist.  In  such  situations 
I  always  think  of  myself  in  a  passive  role,  and  have  to  force  my  feelings, 
in  order  to  think  of  myself  in  any  other  position.  In  this,  I  am  truly 
feminine.  Great  as  my  desire  may  be  to  approach  certain  persons,  my 
struggle  is  as  great  not  to  allow  this  to  be  noticed.  Moustaches,  abund- 
ance of  hair,  and  even  dirt,  seem  to  be  especially  enticing.  It  is  hardly 
necessary  to  say  that,  to  me,  my  condition,  with  reference  to  society,  is 
absolutely  desperate  ;  and,  if  I  had  not  the  hope  of  finding  a  being  that 
would  understand  me,  life  would  be  scarcely  endurable.  I  feel  that 
sexual  commerce  with  a  man  is  the  only  means  of  successfully  combating 
my  impulse  to  onanism.  Though  this  has  a  very  bad  effect  on  me,  I 
cannot  keep  myself  from  it  constantly,  because,  as  I  have  often  found, 
I  will  be  even  more  weakened  by  pollutions  at  night  and  persistent 
erections  during  the  day. 

"  Up  to  this  time  I  have  truly  loved  but  two  men.  Both  were 
officers,  remarkably  endowed  mentally,  handsomely  and  gracefully  formed, 
and  of  dark  skin  and  eyes.  I  became  acquainted  with  the  first  at  the 
University.  I  was  madly  in  love  with  him,  and  suffered  unspeakably  on 
account  of  his  indifference.  I  spent  nights  under  his  window,  simply 
to  be  near  him.     When  he  was  officially  transferred,  I  was  in  despair. 

"  Soon  after,  I  became  acquainted  with  an  officer  that  resembled 
him,  who  likewise  enchained  me  at  first  sight.  I  sought  every  opportu- 
nity to  meet  him,  spent  the  day  in  the  streets,  and  at  places  where  I 
hoped  to  get  a  sight  of  him.  I  knew  how  the  blood  came  into  my  face 
when,  unsuspected,  I  saw  him.  When  I  saw  him  friendly  with  others, 
I  could  scarcely  contain  myself  for  jealousy.  When  I  sat  near  him,  I 
was  impelled  to  touch  him.  I  could  scarcely  conceal  my  excitement 
when  I  touched  his  knee  or  thigh.  I  never  ventured,  however,  to  express 
my  feelings  to  him ;  for,  from  his  conduct,  I  was  convinced  that  he  would 
not  understand  them  or  share  them. 

"  I  am  twenty-seven  years  old,  of  medium  height,  and  well-developed, 
and  would  be  considered  handsome.  My  chest  is  somewhat  narrow, 
hands  and  feet  small,  and  voice  weak.  Mentally,  I  think  I  am  well  en- 
dowed ;  for  I  passed  the  State  examination  with  distinction,  speak  several 
languages,  and  am  a  good  painter. 

23 


354  PSYCHOPATHIA   SEXUALIS. 

"  In  my  calling  I  pass  for  one  that  is  industrious  and  conscientious. 
My  acquaintances  think  me  cold  and  peculiar.  I  do  not  smoke,  do  not 
play  games,  and  cannot  sing  or  whistle.  My  gait,  like  my  voice,  is  some- 
what affected.  I  have  much  taste  for  elegance,  love  adornment,  sweet- 
meats, and  perfumes,  and  prefer  the  society  of  ladies." 

From  Dr.  von  Schrenk's  notes  of  the  case,  it  is  learned,  further, 
that  social  and  criminal  deterrents,  on  the  one  hand,  and  uncontrollable 
desire  for  his  own  sex,  on  the  other,  caused  violent  mental  struggles,  and 
made  life  unendurable.  For  this  reason  the  patient  confided  in  the 
plrysician.  January  22,  1889,  hypnotic  treatment,  with  suggestion,  after 
the  method  of  Nancy,  was  begun  with  the  patient.  Gradually  it  became 
possible  to  induce  somnambulism. 

The  suggestions  were  made  with  reference  to  indifference  to  men, 
and  ability  to  resist  them,  and  to  increase  of  interest  in  women  ;  mastur- 
bation was  thus  forbidden,  and  women  substituted  for  men  in  lascivious 
dreams.  After  a  few  sittings  pleasure  at  sight  of  women  was  induced. 
At  the  seventh  sitting  successful  coitus  was  suggested;  this  was  fulfilled. 

During  the  next  three  months  the  patient  remained,  under  the  in- 
fluence of  occasional  hypnotic  suggestions,  in  the  full  possession  of 
normal  sexual  functions.  April  22,  1889,  there  was  a  relapse,  induced  by 
a  companion.  At  the  next  sitting,  remorse  and  shame.  As  expiation, 
coitus  with  a  woman  in  the  presence  of  his  seducer. 

The  patient  complained  that  coitus  with  women  below  him  in  station 
did  not  satisfy  his  aesthetic  feelings.  He  hoped  to  find  satisfaction  in  a 
happy  marriage.  After  fortj'-five  sittings  (Ma3*  2,  1889)  the  patient  con- 
sidered himself  cured.  Treatment  ceased.  He  became  engaged  to  a 
young  lady  some  weeks  later,  and  presented  himself  again,  after  six 
months,  as  a  happy  bridegroom.  He  thought  that,  in  his  happiness  with 
his  wife,  he  had  a  sure  preventive  against  relapse. 

The  author  emphasizes  the  fact  that  the  hypnotic  treatment  had 
no  injurious  collateral  effect,  and  leaves  undecided  the  question  as  to 
whether  the  cure  is  permanent  or  not,  with  R.'s  very  bad  heredity. 
But  he  expresses  the  conviction  that,  in  case  of  relapse,  renewed  hyp- 
notic treatment  would  not  be  contra-indicated. 

Since  the  incredible  result  of  this  case  interested  me  exceed- 
ingly, as  did  its  further  course,  I  wrote  to  the  author,  requesting 
information  concerning  his  patient. 

Dr.  v.  Schrenk  very  kindly  placed  at  my  disposal  the  follow- 
ing letter,  which  he  had  received  from  the  patient  in  January, 
1890:— 

"  Ity  means  of  suggestive  treatment  given  me  by  Baron  Schrenk, 
for  the  first  time  I  became  possessed   of  the  psychical  condition  that 


THERAPY.  355 

permitted  me  to  have  intercourse  with  a  woman,  which,  up  to  that  time, 
in  spite  of  repeated  efforts,  I  had  been  unable  to  do  successfully. 

"  Since  my  aesthetic  needs  were  unsatisfied  by  intercourse  with 
prostitutes,  I  thought  to  find  my  real  salvation  in  matrimony.  The 
earlier  friendly  inclination  toward  a  lady  known  in  my  youth  offered  me 
the  opportunity,  the  more  because  I  believed  that  she,  of  all  others,  would 
be  in  a  position  to  awaken  feelings  for  the  opposite  sex  which  were  abso- 
lutely foreign  to  me.  Her  character, — i.e.,  our  harmony, — is  in  such 
accord  with  my  inclinations  that  I  am  fully  convinced  that  I  shall  also 
find  complete  psychical  satisfaction.  This  conviction  has  not  changed 
during  the  eight  months  of  my  engagement. 

u  I  intend  to  be  married  in  about  four  weeks. 

"  As  far  as  my  position  with  respect  of  my  own  sex  is  concerned, 
my  power  of  resistance — and  this  is  the  lasting  positive  result  of  this 
treatment — is  absolutely  changed  in  degree.  While  previously  it  was 
impossible  for  me  to  overcome  an  intense  sexual  excitation  when  I  saw  a 
finely  formed  car-driver,  to-day,  in  the  company  of  my  former  lovers,  I 
am  without  sexual  excitement.  At  the  same  time,  I  must  add  that  now, 
as  formerly,  their  society  has  a  certain  attraction  for  me,  though  it  is 
not  to  be  compared  with  my  earlier  passion. 

"  On  the  other  hand,  I  have  refused  repeated  persuasions  to  indulge 
in  sexual  intercourse  with  men,  without  expending  much  force  in  resist- 
ance,— persuasions  which  formerly  I  should  have  been  unable  to  resist. 
I  may  say,  indeed,  that  it  is  a  feeling  of  compassion  for  my  former  lovers, 
that  have  proved  their  passionate  devotion  to  me,  which  keeps  me  from 
directly  repulsing  them.  My  action  seems  to  be  due  to  a  feeling  of  duty, 
rather  than  to  inner  need. 

"  Since  the  conclusion  of  treatment,  I  have  not  consorted  with  pros- 
titutes. This  circumstance,  and  the  numerous  letters  and  persuasions 
from  my  former  lover,  may  well  be  the  reason  why,  in  the  eight  months 
that  have  elapsed,  I  have  allowed  him  to  persuade  me  to  sexual  intercourse 
on  three  or  four  occasions.  At  these  times  I  have  always  been  conscious 
of  being  completely  master  of  myself,  as  compared  with  my  earlier  pas- 
sionate condition  in  like  situations,  as  the  violent  reproaches  of  my  friend 
convinced  me.  I  always  feei  a  certain  unconquerable  repugnance,  ivhich 
cannot  be  based  on  moral  grounds,  but  which,  I  believe,  must  be  attributed 
to  the  treatment.  I  no  longer  feel  a  love  for  him  in  the  former  sense. 
Besides,  since  the  treatment,  I  have  sought  no  opportunities  for  sexual 
intercourse  with  men,  and  I  feel  no  need  of  it.  But,  formerly,  not  a  day 
passed  on  which  I  did  not  feel  impelled  to  it,  so  that  at  times  I -was 
unable  to  think  of  anything  else.  Awake  or  dreaming,  ideas  of  sexual 
content  are  very  infrequent. 

"  I  may  express  the  belief  that  my  marriage,  that  is  to  take  place 
in  a  few  weeks,  and  the  much  desired  change  of  place  that  is  bound  to  it, 
will  entirely  remove  the  residuum  of  my  earlier  condition.     I  conclude 


356  PSYCHOPATHIA    SEXUALIS. 

these  lines  with  the  honest  assurance  that,  subjectively,  I  am  another  man, 
and  that  this  change  has  restored  the  mental  equilibrium  that  was 
previously  wanting." 

The  foregoing  words,  which  Dr.  v.  Schrenk  completes  with 
the  verbal  statement  of  the  patient  that  he  had  not  practiced 
onanism  again,  are  a  brilliant  proof  of  the  lasting  effect  of  post- 
hypnotic suggestion.  I  consider  the  hetero-sexual  instinct  of 
the  patient  to  be  the  artificial  creation  of  his  excellent  physician ; 
and  the  patient  himself  seems  to  recognize  this,  in  that  he 
speaks  of  a  repugnance  which  "does  not  rest  on  moral  grounds, 
but  which  depends  on  the  treatment." 

The  further  fate  of  this  interesting  patient  may  be  learned 
from  the  following  letter,  kindly  submitted  by  Dr.  v.  Schrenk: — 

"  Honored  Sir :  Having  been  home  some  days  from  my  wedding- 
journey,  I  wish  to  send  you  a  short  report  of  my  present  condition. 
During  the  week  before  my  wedding  I  was  in  great  excitement,  because 
I  feared  that  I  should  be  unable  to  perform  certain  duties.  The  impelling 
thoughts  of  my  friend,  who  wished  another  meeting  with  me,  at  any 
price,  had  no  effect  on  me.  We  had  not  seen  each  other  since  I  heard 
from  you  last.  [Receipt  of  the  professor's  letter.]  However,  I  was 
much  troubled  with  the  thought  that  my  marriage  must  be  unhappy. 
Now,  however,  I  have  no  anxiety.  To  be  sure,  on  the  first  night,  success 
was  difficult, — to  induce  •  sexual  excitation  in  myself, — but  on  the  follow- 
ing night,  and  since,  the  influences  needed  for  a  normal  man,  I  believe, 
would  have  been  sufficient  for  me.  I  am  also  convinced  that  the  harmony 
between  us,  which,  of  course,  is  mentally  of  long  standing,  will  become 
more  and  more  complete.  A  relapse  to  the  former  condition  seems 
impossible.  It  is,  perhaps,  significant  for  my  present  condition,  that  I 
one  night  dreamed  of  my  former  lover,  and  that  the  dream  was  not 
sensual,  and  did  not  excite  me  sensually. 

"  I  am  satisfied  with  my  present  circumstances.  I  am,  of  course, 
well  aware  that  my  present  inclinations  ate  far  from  being  of  a  degree 
equal  to  what  they  formerly  were.  I  believe,  however,  that  they  will 
daily  grow  stronger.  Ahead}'  my  former  life  is  incomprehensible,  and  I 
cannot  understand  why  I  did  not  earlier  think  to  overcome  the  abnormal 
sexual  instinct  by  normal  sexual  indulgence.  A  relapse  would  now  be 
possible  only  with  an  entire  change  of  my  mental  life;  and,  in  a  word,  it 
seems  impossible. 

"  Your  obedient  servant,  d." 

From  a  letter  of  Dr.  v.  Schrenk's,  of  December  7th,  I 
extract  the  following : — 


THERAPY.  857 

"  In  this  case  the  cure  seems  to  be  of  longer  duration  than  I  ex- 
pected ;  for,  on  speaking  with  the  patient,  some  months  ago,  he  said  that 
he  was  perfectly  happy  in  marriage,  and,  as  I  hear,  he  expects  soon  the 
happiness  of  a  father." 

Dr.  v.  Schrenk  has  reported  in  the  Wiener  inter nationalen  klinischen 
Rundschau,  1891,  No.  26,  later  and  very  interesting  facts  concerning  his 
patient,  which,  therapeutically,  are  very  satisfactory. 


IV.  SPECIAL  PATHOLOGY. 


THE  MANIFESTATIONS   OF  ABNORMAL   SEXUAL  LIFE  IN 

THE  VARIOUS  FORMS  AND  STATES  OF  MENTAL 

DISTURBANCE. 

Arrest  of  Mental  Development. 

Sexual  life  in  idiots  is,  in  general,  but  slightly  developed. 
It  is  wanting  entirely  in  idiots  of  high  grade.  In  such  instances 
the  genitals  are  frequently  small  and  deformed,  and  menstrua- 
tion is  late  or  does  not  occur  at  all.  There  is  impotence,  or 
sterility,  as  the  case  may  be.  Even  in  idiots  of  low  grade, 
sexuality  is  not  prominent.  In  infrequent  cases  it  is  manifested 
with  a  certain  periodicity,  and  then  with  greater  intensity.  It 
may  then  be  expressed  impulsively,  and  be  violently  satisfied. 
Perversions  of  the  sexual  instinct  do  not  occur  at  the  lowest 
levels  of  mental  development. 

When  the  desire  for  sexual  satisfaction  is  opposed  in  these 
cases,  great  passion  is  excited,  with  danger  of  murderous 
assault  on  the  persons  attacked.  It  is  to  be  expected  that 
idiots  should  not  exercise  choice,  and  they  attempt  to  satisfy 
the  sexual  instinct  on  their  nearest  relatives. 

Thus  Marc-Ideler  reports  the  case  of  an  idiot  who  attempted  to 
rape  his  sister,  and  had  almost  strangled  her  when  he  was  discovered. 

Friedreich  reports  an  analogous  case  (Friedreich's  Blatter,  1858, 
p.  50). 

I  have  repeatedly  had  occasion  to  give  opinions  in  cases  of  attempts 
to  rape  little  girls. 

Giraud  (Annal.  med.  psych.,  1885,  Nr.  1)  also  reports  a  case  of  this 
kind.  Consciousness  of  the  significance  of  the  act  is  always  wanting ; 
an  instinctive  knowledge  that  such  obscene  acts  are  not  publicly  per- 
mitted is  often  present,  and  causes  the  attempted  sexual  act  to  be 
undertaken  in  a  deserted  place. 

In  imbeciles  the  sexual  instinct  is  usually  developed  as  in 
normal  individuals.      The  moral  inhibitory  ideas  are  cloudy, 
(358)     . 


IMBECILITY.  359 

and,  therefore,  the  sexual  impulse  is  more  or  less  openly  mani- 
fested. For  this  reason  imbeciles  are  sources  of  disturbance  in 
society.  Abnormal  intensity  and  perversion  of  the  sexual 
instinct  are  infrequent. 

The  most  frequent  manner  of  satisfaction  of  the  sexual 
desire  is  onanism.  The  weak-minded  seldom  make  sexual 
attacks  on  adults  of  the  opposite  sex. 

Sexual  satisfaction  with  animals  is  frequently  attempted. 
The  great  majority  of  cases  of  injury  (sexual)  to  animals  must 
be  attributed  to  imbeciles.  Children  are  quite  often  their 
victims. 

Emminghaus  (Maschka's  Handb.  iv.,  p.  234)  draws  attention  to  the 
frequency  of  open  manifestation  of  sexual  instinct,  which  comprises 
open  masturbation,  exhibition  of  the  genitals,  attacks  on  children  and 
those  of  the  same  sex,  and  sodomy. 

Giraud  (Anna!.  mSd.  psycho!.,  1855,  Nr.  1)  has  reported  a 
whole  series  of  immoral  attacks  on  children : — 

1.  H.,  aged  17,  imbecile,  enticed  a  little  girl  into  a  barn,  by  giving 
her  nuts.  There  he  exposed  her  genitals  and  showed  his  own,  making 
movements  of  coitus  on  the  child's  abdomen.  He  had  no  idea  of  the 
moral  significance  of  the  act. 

2.  L.,  aged  21 ;  imbecile ;  degenerate.  While  he  was  watching  cattle, 
his  sister  of  eleven  }rears,  with  a  playmate  of  eight  years,  came  and  told 
him  how  some  unknown  man  had  attempted  to  do  them  violence.  L. 
led  the  children  to  a  deserted  house  and  attempted  coitus  with  the 
younger  child,  but  let  her  go  because  no  emission  occurred,  and  because 
the  child  cried  out.  On  the  way  home  he  promised  to  many  her  if  she 
would  not  say  anything.  At  the  trial  he  thought  that  by  marriage  he 
could  right  the  wrong  he  had  done.1 

3.  G.,  aged  21,  microcephalic,  imbecile,  has  masturbated  since  his 
sixth  year,  and  practiced  active  and  passive  pederasty.  He  has  repeat- 
edly tried  to  perform  pederasty  with  boys,  and  attacked  little  girls.  He 
was  absolutely  without  an  understanding  of  his  acts.  His  sexual  desire 
was  manifested  periodically  and  intensely,  as  in  animals.2 

1  For  numerous  cases,  v.  Ilenke's  Zeitschr.,xxiii. — Erganzungsheft,  p.  147. — Combes, 
Annal.  med.  psychol.,  1806. — Linian,  Zweifelh.  Geisteszustande,  p.  389. — Casper-Liman, 
Lehrb.,  7.  Auflage,  Fall  295.— Battels,  Friedreich's  Blatter  f.  gerichtl.  Med.,  1890,  Heft  1. 

2  Other  cases  of  pederasty,  v.  Casper,  Klin.  Novellen,  Fall  5 ;  Combes,  Annal.  m6d. 
psychol. 


360  PSYCHOPATHIA   SEXUALIS. 

4.  B.,  aged  21 ;  imbecile.  While  alone  in  a  forest  with  his  sister  of 
nineteen,  he  demanded  that  she  allow  coitus.  She  refused.  He  threat- 
ened to  strangle  her,  and  stabbed  her  with  a  knife.  The  frightened  girl 
fondled  his  penis,  and  he  then  left  her  and  quietly  went  on  with  his  work. 
B.  has  a  deformed,  microcephalic  skull,  and  has  no  sense  of  the  signifi- 
cance of  his  act. 


Emminghaus  {op.  cit.,  p.  234)  reports  the  case  of  an 
exhibitionist : — 

Case  146.  A  man,  aged  40,  married,  had  for  sixteen  years  been 
accustomed  to  exhibit  himself  in  parks,  at  dusk,  to  little  girls  and  ser- 
vants, and  drew  their  attention  to  himself  by  whistling.  After  having 
been  frequently  punished  for  it,  he  avoided  the  places,  but  he  carried  on 
his  practice  elsewhere.  Hydrocephalus.  Mental  weakness  of  slight 
degree.     Mild  sentence  passed. 

Case  147.  X.,  of  tainted  family;  imbecile;  defective  and  perverted 
in  intellect,  feeling,  and  will.  For  help  and  protection  he  was  brought 
before  an  officer.  It  was  complained  that  he  had  repeatedly  exposed 
his  genitals  to  servant-girls,  and  had  shown  himself  at  windows  with 
the  upper  portion  of  his  body  naked.  No  other  manifestations  of 
sexual  instinct.  No  onanism  reported.  (Sander,  Archiv  f.  Psych.,  i, 
p.  655.) 

Case  148.  Pederasty  with  a  Child. — On  April  8, 1884,  at  ten  o'clock 
a.m.,  while  X.  was  sitting  on  the  street,  holding  a  boy  of  eighteen  months 
on  her  lap,  a  certain  Vallario  approached  and  took  the  child  from  X., 
saying  he  was  going  to  take  it  for  a  walk.  He  went  the  distance  of  half 
a  kilometre,  and  returned,  saying  that  the  child  had  fallen  from  his  arms, 
and  thus  injured  its  anus.  The  anus  was  torn,  and  blood  was  pouring 
from  it.  At  the  place  where  the  deed  was  done,  traces  of  semen  were 
found.  V.  confessed  his  horrible  crime,  and,  at  his  final  trial,  he  acted 
so  strangely  that  an  examination  of  his  mental  condition  was  made.  He 
had  impressed  the  prison  attendants  as  being  an  imbecile.  V.,  aged 
45,  mason,  defective  morally  and  intellectually,  is  dolicho-microcephalic  ; 
has  narrow,  deformed  facial  bones,  and  the  halves  of  the  face  and 
the  ears  are  asymmetrical;  the  brow  is  low  and  retreating;  genitals 
normal.  V.  shows  general  diminution  of  cutaneous  sensibility,  is  im- 
becile, and  has  no  ideas.  He  lives  in  the  present,  has  no  ambition,  and 
does  nothing  of  his  own  will.  He  has  no  desires  and  no  emotional 
feeling.  He  has  never  had  coitus.  Nothing  more  could  be  ascer- 
tained about  his  vita  sexualis.  Proofs  of  intellectual  and  moral  idiocy, 
due  to  microcephaly ;  the  crime  is  referred  to  a  perverse,  uncontrollable 
sexual  impulse.  Sent  to  an  asylum.  (Virgilio,  il  Manicomio,  V.  year, 
No.  3.) 


DEMENTIA.  361 

A  case  mentioned  by  L.  Meyer  {Arch.  f.  Psych.,  Bd.  i,  p. 
103)  shows  how  female  imbeciles  may  indulge  in  shameless 
prostitution  and  immorality.1 

States  of  Acquired  Mental  Weakness. 

The  numerous  anomalies  of  the  vita  sexualis  in  senile 
dementia  have  been  described  in  the  section  on  "General 
Pathology."  In  other  conditions  of  acquired  mental  weakness, 
— those  due  to  apoplexy ;  trauma  capitis ;  to  the  secondary 
stages  of  psychoses ;  or  to  inflammatory  processes  in  the  cortex 
(lues,  paretic  dementia), — perversions  of  the  sexual  instinct 
seem  to  be  infrequent ;  and  here  the  immoral  sexual  acts  seem 
to  depend  on  abnormally  increased  or  uninhibited  sexual  feeling, 
which,  in  itself,  is  not  abnormal. 

(1)  Dementia  Consecutive  to  Psychoses. 

Casper  (Kiln.  Novellen,  Fall  31)  reports  a  case  that  belongs 
here.  It  is  that  of  a  physician,  aged  33,  who  attempted  rape 
on  a  child.  He  was  weakened  mentally,  as  a  result  of  hypo- 
chondriacal melancholia.  He  excused  his  deed  in  a  very 
silly  way,  and  had  no  appreciation  of  the  moral  and  criminal 
meaning  of  the  act,  which  was  apparently  the  result  of  a  sexual 
impulse  that  could  not  be  controlled  on  account  of  his  mental 
weakness. 

Case  21,  in  Liman's  Zweifelhafte  Geisteszustanden,  is  an 
analogous  case  (dementia  after  melancholia;  offense  against 
morals  by  exhibition). 

(2)  Dementia  After  Apoplexy. 

Case  149.  B.,  aged  52.  He  passed  through  a  cerebral  attack,  and 
was  no  longer  able  to  carry  on  his  business  as  a  merchant. 

One  day,  in  the  absence  of  his  wife,  he  locked  two  girls  in  the 
house,  gave  them  liquors  to  drink,  and  then  carried  out  sexual  acts  with 
the  children.  He  commanded  them  to  say  nothing,  and  went  to  his 
business.  The  medical  expert  established  mental  weakness,  resulting 
from  repeated  apoplexies.      B.,  who,  up  to  this  time,  had  been  well- 

1  V.  Sander,  Vierteljahrsschr.  f.  ger  M.,  xviii,  p.  31. — Casper,  Klin.  Novellen,  Fall  27. 


362  PSYC0OPATHIA    SEXUALIS. 

behaved,  says  he  committed  the  criminal  act  because  of  an  uncontrollable 
and  incomprehensible  impulse ;  and  that,  when  he  came  to  himself,  he 
was  ashamed,  and  sent  the  girls  away.  Since  his  apoplectic  attack,  B. 
had  been  weak-minded,  incapable  of  business,  and  hemiplegic  ;  but,  soon 
after  arrest,  he  made  an  unskillful  attempt  at  suicide.  He  often  cried 
childishly.  His  moral  and  intellectual  energy  in  opposing  his  sensual 
impulses  was  certainly  much  weakened.  No  sentence.  (Griraud,  Ann. 
med.  Psychol.  March,  1881.) 

(3)  Dementia  After  Injury  of  Head. 

Case  150.  K.,  when  fourteen  3'ears  old,  was  injured  on  the  head  by 
a  horse.  The  skull  was  fractured  iu  several  places,  and  several  pieces  of 
bone  required  removal. 

From  that  time  K.  was  weak  mentally,  passionate,  and  ill-tempered. 
Gradually  he  developed  an  inordinate  and  truly  beastly  sensuality,  which 
drove  him  to  the  most  immoral  acts.  One  day  he  raped  a  girl  of  twelve, 
and  strangled  her  for  fear  of  discovery.  Arrested,  he  confessed.  The 
medical  experts  declared  him  responsible,  and  he  was  executed. 

The  autopsy  revealed  ossification  of  almost  all  the  sutures,  remark- 
able asymmetry  of  the  halves  of  the  skull,  and  evidences  of  healed 
fractures.  The  affected  hemisphere  had  bands  of  cicatricial  tissue  run- 
ning through  it,  and  was  one-third  smaller  than  the  other.  (Friedreich's 
Blatter,  1885,  Heft  6.) 

(4)  Acquired  Mental  Weakness,  Probably  Resulting  from  Lues. 

Case  151.  X.,  officer,  had  repeatedly  committed  immoral  acts  with 
little  girls;  among  other  things,  he  had  induced  them  to  perform  manus- 
tupration  on  him,  had  exposed  his  genitals,  and  handled  theirs. 

X.,  formerly  health}',  and  of  blameless  life,  was  infected  with 
syphilis  in  1867.  In  1879  paralysis  of  the  left  abducens  occurred. 
Thereafter  mental  weakness  was  noticed,  with  a  change  of  his  disposi- 
tion and  character.  Headache,  occasional  incoherence  of  speech,  failure 
of  power  of  thought  and  logic,  occasional  inequality  of  pupils,  and 
paresis  of  the  right  facial  muscles,  were  observed. 

X.,  aged  37,  shows  no  trace  of  lues  when  examined.  The  paralysis 
of  the  left  abducens  is  still  present.  The  left  eye  is  amblyopic.  He  is 
mentallj'  weak.  Concerning  the  trial  that  was  before  him,  he  said  it  was 
nothing  but  a  harmless  misunderstanding.  Indications  of  aphasia. 
Weakness  of  memory,  particularly  for  recent  events.  Superficial  emo- 
tional reaction  ;  rapid  exhaustion  of  memory  and  ability  to  speak. 
Proved  :  that  the  ethical  defect  and  the  perverse  sexual  impulse  are  the 
symptoms  of  an  abnormal  condition  of  brain  induced  hy  lues. 

Suspension  of  criminal  proceedings.  (Personal  case.  Jahrb'ucher 
fur  Psychiatric) 


DEMENTIA.  363 

(5)  Paretic  Dementia. 

Here  the  sexual  life  is  usually  abnormally  affected ;  in 
the  incipient  stages  of  the  disease,  as  well  as  in  episodical 
states  of  excitement,  it  is  intensified,  and  sometimes  perverse. 
In  the  final  stages  libido  and  sexual  power  usually  become 
nil. 

Just  as  in  the  prodromal  stage  of  the  senile  forms,  one 
sees  here,  in  connection  with  more  or  less  evident  losses  in  the 
moral  and  intellectual  spheres,  expressions  of  an  apparently 
intensified  sexual  instinct  (obscene  talk,  openness  in  intercourse 
with  the  opposite  sex,  thoughts  of  marriage,  frequenting  of 
brothels,  etc.),  which  is  characteristic  of  the  clouding  of  con- 
sciousness. 

Seduction,  abduction,  and  public  scandal  are  here  the  order 
of  the  day.  At  first  there  is  still  some  appreciation  of  the 
circumstances,  though  the  cynicism  of  the  acts  is  striking 
enough.  As  the  mental  weakness  increases,  such  patients 
become  criminal  by  reason  of  exhibition,  masturbation  in  the 
streets,  and  attempts  at  immoral  acts  with  children. 

If  conditions  of  mental  excitement  come  on,  attempts  at 
rape  are  committed,  or,  at  least,  grossly  immoral  acts, — the 
patient  attacks  women  on  the  street,  appears  in  public  in  very 
imperfect  dress ;  or,  half-clothed,  tries  to  force  his  way  into 
strange  houses,  to  cohabit  with  the  wife  of  an  acquaintance,  or 
to  marry  the  daughter  on  the  spot. 

Numerous  cases  belonging  to  this  category  are  cited  by  Tardieu 
("  Attentats  aux  moeurs  ") ;  Mendel  ("  Progressive  Paratyse  der  Irren," 
1880,  p.  123);  Westplial  {Arch.  f.  Psych.,  vii,  p.  622);  and  a  case  by 
Petrucci  (Annal.  med.  Psychol.,  1875)  shows  that  bigamy  ma}'  also  occur 
here. 

The  brutal  disregard  of  consequences  with  which  the  patients  in 
the  advanced  stages  attempt  to  satisfy  their  sexual  instinct,  is  charac- 
teristic. 

In  a  case  reported  by  Legrand  ("  La  folie,"  p.  519),  the  father  of  a 
family  was  found  masturbating  in  the  open  street.  After  the  act  he 
consumed  his  semen. 

A  patient  seen  by  me,  an  officer,  of  a  prominent  family,  in  broad 
daylight,  made  attacks  on  little  girls  at  a  watering-place. 


364  PSTCHOPATHIA   SEXUALIS. 

A  similar  case  is  reported  by  Dr.  Regis  ("  De  la  dynamie  ou  exalta- 
tion fonctionnelle  ail  debut  de  la  paral.  gen.,"  1878). 

Cases  reported  by  Tarnowsky  {op.  cit.,  p.  82)  show  that  also  peder- 
asty and  bestiality  may  occur  in  the  prodromal  stages  and  course  of 
this  malady. 

JEpilepsy. — Epilepsy  is  allied  to  the  acquired  states  of 
mental  weakness  because  it  often  leads  to  them,  and  then  all 
the  possibilities  of  reckless  satisfaction  of  the  sexual  impulse 
that  have  been  mentioned  may  occur.  Moreover,  in  many 
epileptics  the  sexual  instinct  is  very  intense.  For  the  most 
part,  it  is  satisfied  by  masturbation,  now  and  then  by  attacks 
on  children,  and  by  pederasty.  Perversion  of  the  instinct  with 
perverse  sexual  acts  seems  to  be  infrequent. 

Much  more  important  are  the  numerous  cases  in  literature 
in  which  epileptics,  who,  during  intervals,  present  no  signs  of 
active  sexual  impulse,  but  manifest  it  in  connection  with  epileptic 
attacks,  or  during  the  time  of  equivalent  or  post-epileptic 
exceptional  mental  states.  These  cases  have  scarcely  yet  been 
studied  clinically,  and  forensically  not  at  all ;  but  they  deserve 
careful  study.  In  this  way  certain  cases  of  violence  and  rape 
would  be  understood,  and  legal  murders  prevented. 

From  the  following  facts,  it  will  certainly  be  clear  that  the 
cerebral  changes  which  accompany  the  epileptic  outbreak  may 
induce  an  abnormal  excitation  of  the  sexual  instinct.  Besides, 
in  the  exceptional  mental  states  of  epileptics,  they  are  unable 
to  resist  their  impulses,  by  reason  of  the  disturbance  of  con- 
sciousness. 

For  years  I  have  known  a  young  epileptic,  of  bad  heredity,  who, 
always  after  frequent  epileptic  seizures,  attacks  his  mother,  and  tries  to 
violate  her.1  After  a  time  he  comes  to  himself,  and  has  no  memory  of 
his  acts.  In  the  intervals  he  is  very  strict  in  morals,  and  has  but  slight 
sexual  inclination. 


1  Arndt  (Lehrb.  d.  Psych.,  p.  410)  especially  emphasizes  the  passionate  element  in 
epileptics  :  "  I  have  known  epilepsy  that  expressed  itself  in  a  most  sensual  way  toward  the 
mother,  and  that  that  rested  under  a  suspicion  on  the  part  of  fathers,  concerning  sexual 
intercourse  with  the  mothers."  But  when  Arndt  declares  that,  wherever  there  is  a  pecu- 
liarity of  the  6exual  life,  thought  of  an  epileptic  element  should  come  into  consideration, 
he  is  in  error. 


EPILEPSY.  365 

Some  years  ago  I  became  acquainted  with  a  young  peasant,  who, 
during  epileptic  attacks,  masturbated  shamelessly,  but  during  the  inter- 
vals was  above  reproach. 

Simon  ("  Crimes  et  de'lits,"  p.  220)  mentions  an  epileptic  girl  of 
twenty-three,  well  educated,  and  of  the  best  morals,  who,  in  attacks  of 
vertigo,  would  shout  out  obscene  words,  then  raise  her  dress,  make  las- 
civious movements,  and  try  to  tear  open  her  under-garments. 

Kiernan  (Alienist  and  Neurologist,  January,  1884)  reports  the  case 
of  an  epileptic  who  always  had,  as  an  aura,  the  vision  of  a  beautiful 
woman  in  lascivious  attitudes,  which  induced  ejaculation.  After  some 
years,  with  treatment  with  potassium  bromide,  the  vision  was  changed  to 
that  of  a  devil  attacking  him  with  a  pitchfork.  The  instant  this  reached 
him,  he  became  unconscious. 

The  same  author  speaks  of  a  very  respectable  man  who  had,  two 
or  three  times  a  year,  epileptic  attacks  of  furor  and  dysthymia,  with 
impulses  to  pederasty,  which  lasted  a  week  or  two ;  and  of  a  lady  who, 
with  epilepsy  that  came  on  during  the  climacterium,  had  sexual  desire 
for  boys. 

Case  152.  W.,  of  good  heredity,  previously  healthy;  before  and 
after,  sound  mentally,  quiet,  kind,  temperate.  On  April  13,  1877,  he  had 
no  appetite.  On  the  14th,  in  the  presence  of  his  wife  and  children,  he 
demanded  coitus,  first  of  his  wife's  friend,  who  was  present,  then  of  his 
wife.  Taken  away,  he  had  an  epileptoid  attack ;  after  this  he  became 
wildly  maniacal  and  destructive,  threw  hot  water  on  those  that  tried  tc* 
approach  him,  and  threw  a  child  in  the  stove.  Then  he  soon  became 
quiet,  but  for  some  days  remained  confused,  and  finally  came  to  himself 
with  no  memory  of  the  events  of  his  attack.  (Kowalewsky,  Jahrbucher 
f.  Psych.,  1879.) 

Another  case,  examined  by  Casper  (Klin.  Novellen,  p.  267),  may 
be  attributed  to  epilepsy  (larvated).  A  respectable  man  attacked  four 
women,  one  after  another,  in  the  open  street  (once  before  two  witnesses), 
and  violated  one  of  them,  "  notwithstanding  that  his  young,  pretty,  and 
healthy  wife  "  lived  hard  by. 

The  epileptic  significance  of  the  sexual  acts  in  the  follow- 
ing cases  is  unequivocal : — 

Case  153.  L.,  official,  aged  40 ;  a  kind  husband  and  father.  During 
four  years  he  has  offended  public  morals  twenty-five  times,  for  which  he 
has  had  to  endure  long  imprisonment. 

In  the  first  seven  complaints  he  was  accused  of  exposing  his  geni- 
tals to  girls  from  eleven  to  thirteen  years  old,  while  riding  by  them,  and 
calling  their  attention  by  obscene  words.  While  in  confinement,  he  had 
exposed  his  genitals  at  a  window  which  opened  on  a  popular  street. 


366  PSYCHOPATHIA   SEXUALIS. 

L.'s  father  was  insane;  his  brother  was  once  met  on  the  street 
wearing  only  a  shirt.  During  his  military  service  L.  had  had  two 
attacks  of  severe  fainting.  Since  1859  he  had  suffered  with  peculiar 
attacks  of  vertigo,  at  such  times  becoming  weak,  tremulous,  and  deathly 
pale ;  it  grew  dark  before  his  eyes,  and  he  saw  bright  stars,  and  was 
forced  to  get  support  in  order  to  keep  upright.  After  violent  attacks, 
great  weakness,  profuse  sweating. 

Since  1861  he  had  been  very  irritable,  which,  respected  though  he 
was  as  an  official,  caused  him  much  trouble  in  his  work.  His  wife 
noticed  the  change  in  him.  He  had  days  when  he  would  run  about  the 
house  as  if  insane,  holding  his  head  between  his  hands,  striking  the 
wall,  and  complaining  of  headache.  In  1864  he  fell  to  the  ground  four 
times,  lying  there  stiff,  with  eyes  open.  Confused  states  of  consciousness 
were  also  proved  to  have  occurred. 

L.  declared  that  he  had  not  the  slightest  remembrance  of  the  crime 
of  which  he  was  accused.  Observation  showed  further  and  more  violent 
attacks  of  epileptic  vertigo.  L.  was  not  sentenced.  In  1875  paretic 
dementia  developed  with  a  rapidly  fatal  result.  (Westphal,  Arch.  /.' 
Psych.,  vii,  p.  113.) 

Case  154.  A  rich  man  of  twenty-six  had  lived  for  a  year  with  a 
girl  with  whom  he  was  very  much  in  love.  He  cohabited  iufrequentby, 
and  was  never  perverse. 

Twice  during  the  year,  after  excessive  indulgence  in  alcohol,  he 
.had  had  epileptic  attacks.  .  One  evening  after  dinner,  where  he  had 
taken  much  wine,  he  hurried  to  the  house  of  his  mistress,  and  into 
her  sleeping-apartment,  although  the  servant  told  him  she  was  not  at 
home.  From  there  he  hastened  into  a  room  where  a  boy  of  fourteen 
was  sleeping,  and  began  to  violate  him.  At  the  cry  of  the  child,  whose 
prepuce  and  hand  he  had  injured,  the  servant  hurried  to  them.  He  left 
the  boy  and  attacked  the  maid ;  after  that  he  went  to  bed  and  slept  twelve 
hours.  When  he  awoke,  he«had  an  indistinct  remembrance  of  intoxica- 
tion and  coitus.  Thereafter  there  were  repeated  epileptic  attacks. 
(Tarnowsky,  op.  cit.,  p.  52.) 

Case  155.  X.,  of  high  social  position,  led  a  dissolute  life  for  some 
time,  and  had  epileptic  attacks.  He  became  engaged.  On  his  wedding- 
day,  shortly  before  the  ceremony,  he  appeared,  on  his  brother's  arm, 
before  the  assembled  guests.  When  he  came  before  his  bride,  he  exposed 
his  genitals  and  began  to  masturbate.  He  was  at  once  taken  to  an  expert 
in  mental  disease.  On  the  way  he  constantly  masturbated,  and  for  some 
days  was  actuated  by  this  impulse,  which  gradually  decreased  in  intensity. 
After  this  paroxysm  the  patient  had  only  a  confused  memory  of  the 
events,  and  could  give  no  explanation  of  his  acts.  (Tarnowsky,  op.  cit., 
p.  53.) 

Case  156.  Z.,  aged  27  ;  very  bad  heredity  ;  epileptic.  He  violated  a 
girl  of  eleven,  and  then  killed  her.     He  lied  about  the  deed.     Absence  of 


EPILEPSY.  36T 

memory,  i.e.,  mental  confusion  at  the  time  of  the  crime,  was  not  proved. 
(Pugliese,  Arch,  di  Psich.,  viii,  p.  622.) 

Case  157.  V.,  aged  60,  physician,  violated  children.  Sentenced  to 
imprisonment  for  two  years.  Dr.  Marandon  later  proved  the  existence 
of  epileptoid  attacks  of  apprehensiveness,  dementia,  erotic  and  hypochon- 
driacal delusions,  and  occasional  attacks  of  fear.  (Lacassagne,  Lyon, 
mid.,  1887,  No.  51.) 

Case  158.  On  August  4, 1878,  H.,aged  15,  was  picking  gooseberries 
with  several  little  girls  and  boys  as  her  companions.  Suddenly  she 
threw  L.,  aged  10,  to  the  ground  and  exposed  her,  and  ordered  A.,  aged 
8,  and  0.,  aged  5,  to  bring  about  conjunctio  membrorum  with  the  girl ; 
and  they  obeyed. 

H.  had  a  good  character.  For  five  years  she  had  been  subject  to 
irritability,  headache,  vertigo,  and  epileptic  attacks.  Her  mental  and 
physical  development  had  been  arrested.  She  had  not  menstruated,  but 
she  manifested  menstrual  molimena.  Her  mother  is  suspected  to  be 
epileptic.  For  three  months  H.,  after  seizures,  had  frequently  done 
strange  things,  and  afterward  had  no  memory  of  them. 

H.  seems  to  have  been  deflowered.  Mental  defect  is  not  apparent. 
She  said  she  had  no  memory  of  the  act  of  which  she  was  accused.  Ac- 
cording to  her  mother's  testimony,  she  had  an  epileptic  attack  on  the 
morning  of  August  4th,  and  she  had  been,  on  that  account,  told  by  her 
mother  not  to  leave  the  house.  (PUrkauer,  Friedreich's  Blatter  f.  ger. 
Med.,  1879.) 

Case  159.  Immoral  Acts  of  an  Epileptic  in  States  of  Abnormal 
Unconsciousness. — T.,  revenue -collector;  aged  52;  married.  He  is 
accused  of  having  practiced  immorality  with  bo3rs  for  about  seventeen 
years,  by  practicing  masturbation  on  them,  and  1>3T  inducing  them  to 
carry  out  the  act  on  himself.  The  accused,  a  respected  officer,  is  over- 
come by  the  terrible  crime  attributed  to  him,  and  declares  that  he  knows 
nothing  of  the  deeds  of  which  he  is  accused.  His  mental  integrit}'  is 
questionable.  His  family  physician,  who  has  known  him  twenty  3'ears, 
emphasizes  his  peculiar,  retiring  disposition  and  his  mercurial  moods. 
His  wife  asserts  that  T.  once  tried  to  throw  her  in  the  water,  and  that 
he  sometimes  had  outbreaks  in  which  he  tore  off'  his  clothing,  and  tried 
to  throw  himself  out  of  windows.  T.  knew  nothing  of  these  attacks. 
Other  witnesses  testified  to  strange  changes  of  mood  and  peculiarities 
of  character.  A  physician  reports  the  observation  of  occasional  attacks 
of  vertigo  and  convulsions  in  him. 

T.'s  grandmother  was  insane;  his  father  was  affected  with  chronic 
alcoholism,  and  of  late  years  had  had  epileptiform  attacks.  The  father's 
brother  was  insane,  and  had  killed  a  relative  while  in  a  delirious  state. 
Another  uncle  of  T.  had  killed  himself.  Of  T.'s  three  children,  one  was 
weak-minded,  another  cross-eyed,  and  the  third  was  subject  to  compul- 
sions.    The  accused  asserted  that  he  had  occasional  attacks  in  which 


368  PSYCHOPATHIA    SEXUALIS. 

consciousness  was  so  reduced  that  he  did  not  know  what  he  was  about. 
These  attacks  were  ushered  in  by  an  aura-like  pain  in  the  back  of  his 
neck.  He  was  then  impelled  to  go  out  in  the  air.  He  did  not  know 
where  he  went.  His  wife  had  perfectly  satisfied  him  sexually.  For 
eighteen  years  he  had  had  chronic  eczema  (actual)  of  the  scrotum, 
which  had  often  caused  him  to  have  extraordinary  sexual  excitement. 
The  opinions  of  the  six  experts  were  contradictory  (sane, — attacks  of 
larvated  epilepsy)  ;  the  jury  disagreed,  so  that  he  was  dismissed.  Dr. 
Legrand  du  Saulle,  who  was  called  as  an  expert  witness,  found  that, 
until  his  twenty -second  year,  T.  had  urinated  in  bed  from  ten  to  eighteen 
times  a  year.  After  that  time  the  enuresis  nocturna  had  ceased;  but, 
from  that  time,  states  of  mental  confusion,  lasting  from  an  hour  to  a 
day,  had  occurred  occasionally,  and  they  left  the  patient  without  any 
memory  of  them.  Soon  again  T.  was  arrested  for  public  immorality, 
and  sentenced  to  imprisonment  for  fifteen  months.  In  prison  he  grew 
sick,  and  apparently  much  weaker  mentally.  For  this  reason  he  was 
pardoned,  but  the  mental  weakness  increased.  T.  was  noticed  to  have 
repeated  epileptoid  convulsions  (tonic  convulsion  with  tremor  and  loss 
of  consciousness).  (Auzouy,  Anna  I.  med.  psychol.,  1874,  Nov.;  Legrand 
du  Saulle,  "  Etude  med.  legale,"  etc.,  p.  99.) 

The  following  case  of  immoral  acts  with  children,' observed 
by  the  author  and  reported  in  Friedreich' 's  Blatter,  will  serve  to 
conclude  this  group,1  so  important  in  its  legal  bearings.  It  is 
the  more  important,  in  that  a  state  of  unconsciousness  was 
established  at  the  time  of  the  act,  and  because,  for  allied 
reasons,  the  facts  related  in  Latin  show  how  a  complicated  and 
refined  act  becomes  possible  in  such  a  state  of  unconsciousness. 

Case  160.  P.,  aged  49;  married;  hospital  beneficiary.  He  was 
accused  of  having  committed  the  following  terrible  acts  with  two  girls, 
— D.,  aged  ten,  and  (jr.,  aged  nine, — whom  he  had  taken  to  his  work-shop 
on -May  25,  1883. 

D.  testifies :  "  I  was  in  the  meadow  with  G.  and  my  sister  J.,  aged 
three.  P.  called  us  into  his  shop  and  fastened  the  door.  Turn  nos  exos- 
culabatur,  linguam  in  os  meum  demittere  tentabat  faciemque  mihi  lam- 
bebat ;  sustulit  me  in  gremium,  bracas  aperuit,  Arestes  meas  sublevavit, 
digitis  me  in  genitalibus  titillabat  et  membro  femina  mea  fricabat  ita  ut 
humida  fierem.  When  I  cried,  he  gave  me  twelve  kreuzers,  and  threat- 
ened to  shoot  me  if  I  told  on  him.  At  last  he  tried  to  persuade  me  to 
come  again  the  next  day." 

1  Comp.  also  Liraan,  Zweifelhafte  Geisteszustande,  Fall  6. — Lasegue,  Exhibitionists, 
Union  mod.,  1877. — Ball  and  Chambert,  Art.  Sorunambulisme  (Diet,  des  scienc.  mod.,  1881). 


EPILEPSY.  369 

G.  testified  :  "  P.  nates  et  genitalia  D.  ae  exosculatus,  iisdem  me 
conatibns  aggressus  est.  Deinde  filiolum  quoque  tres  annos  natum  in 
maims  aeceptum  osculatus  est  nudatumque  parti  suae  virili  appressit. 
Postea  quse  nobis  essent  nomina  interrogavit  ac  censuit,  genitalia  D.  ae 
meis  mnlto  esse  majora.  Quin  etiam  nos  impulit,  ut  membrum  snum 
intneremur,  manibus  comprehenderemus  et  videremus,  quantopere  id 
esset  erectam." 

At  bis  examination,  May  29tb,  P.  said  he  bad  but  an  indistinet 
recollection  of  having  fondled,  caressed,  and  made  presents  to  a  little 
girl  a  short  time  before.  If  he  had  done  anything  more,  it  must  have 
been  in  an  irresponsible  condition.  Besides,  he  had  suffered  for  years 
with  weakness  in  his  head,  as  result  of  an  injury.  On  June  22d  he  knew 
nothing  of  the  events  of  Ma}7  25th,  and  nothing  of  his  examination  on 
May  29th.     This  amnesia  was  shown,  also,  on  cross-examination. 

P.  comes  of  a  family  affected  with  cerebral  disease ;  a  brother  was 
epileptic.  P.  was  formerly  a  drinker.  Years  before,  he  had  actually 
suffered  an  injury  to  his  head.  Since  then,  from  time  to  time,  he  has  had 
attacks  of  mental  disturbance,  introduced  by  moroseness,  irritability, 
tendency  to  alcoholic  excesses,  apprehension,  and  delusions  of  persecu- 
tion sufficient  to  induce  threats  and  deeds  of  violence.  At  the  same 
time,  he  would  have  auditory  hyperesthesia,  vertigo,  headache,  and 
cerebral  congestion, — all  this,  with  great  mental  confusion  and  amnesia 
for  the  whole  period  of  the  attack,  which  would  sometimes  last  for 
weeks. 

During  the  intervals  he  was  subject  to  headache,  which  started 
from  the  seat  of  injury  on  the  head  (a  small  scar  in  the  skin  over  the 
right  temple),  which  was  painful  on  pressure.  With  exacerbation  of  the 
headache,  he  became  very  irritable,  morose  to  an  extent  that  inclined 
him  to  suicide,  and  mentally  like  one  drunk.  In  1879,  white  in  such  a 
state,  he  made  an  impulsive  attempt  at  suicide,  of  which  he  afterward 
had  no  memory.  Soon  after  this,  being  sent  to  hospital,  he  gave  the 
impression  of  being  epileptic,  and,  for  a  long  time,  was  treated  with  pot. 
bromide.  At  the  end  of  1879  he  was  taken  to  the  infirmary,  no  actual 
epileptic  attack  having  been  observed. 

During  his  lucid  intervals  he  was  a  virtuous,  industrious,  good- 
natured  man,  and  had  never  shown  any  sexual  excitement;  and,  until 
this  time,  never  sexual  inclinations,  even  during  his  mental  confusion. 
Moreover,  until  lately,  he  had  lived  with  his  wife.  At  the  time  of  the 
criminal  act,  he  had  shown  signs  of  an  approaching  attack,  and  had 
asked  the  physician  to  prescribe  pot.  bromide. 

P.  asserted  that,  since  the  injury  to  his  head,  he  had  been  intolerant 
of  heat  and  alcohol,  which  immediately  brought  on  headache  and  confu- 
sion. The  medical  examination  proved  the  truth  of  his  assertions  about 
mental  weakness,  irritability,  and  poor  sleep. 

If  pressure  were  made  at  the  seat  of  the  trauma,  P.  became  con- 

24 


370  PSYCHOPATHIA   SEXUALIS. 

gested,  irritable,  confused,  and  trembled  all  over;  he  appeared  excited ; 
consciousness  was  disturbed,  and  remained  so  for  hours. 

At  times,  when  he  is  free  from  the  sensations  that  start  from  the 
scar,  he  seems  kind,  free,  willing,  and  open,  though  he  is  mentally  weak 
and  cloudy.  P.  was  not  sentenced.  (  Vide  Friedreich's  Blatter  for  full 
report.) 

Periodical  Insanity. 

Just  as  in  cases  of  non-periodical  mania,  an  abnormal  in- 
tensity or  a  noticeable  prominence  of  the  sexual  sphere  is  very 
often  manifested  in  the  periodical  attacks  (v.  infra,  "Mania"). 

The  following  case,  reported  by  Servaes  {Arch.  f.  Psych.), 
shows  that  it  then  may  also  be  perverted : — 

Case  161.  Catharine  W.,  aged  16 ;  she  has  not  j-et  menstruated ; 
previously  healthy. 

Seven  weeks  before  admission  (December  3,  1872),  melancholic 
depression  and  irritability.  November  27th,  maniacal  outbreak,  lasting 
two  days  ;  thereafter,  melancholic.     December  6th,  normal  condition. 

December  24th  (twenty-eight  days  after  the  first  maniacal  attack), 
silent,  shy,  depressed.  December  27th,  exaltation  (jolly,  laughing,  etc.), 
with  violent  love  for  an  attendant  (female).  December  31st,  suddenly 
melancholic  catalepsy,  which  disappeared  after  two  hours.  January 
20,  1873,  new  attack  like  the  previous  one.  A  similar  one  on  February 
18th,  with  traces  of  menses.  The  patient  had  no  memory  whatever  for 
what  occurred  in  the  paroxysms,  and  blushed  scarlet  with  astonishment 
and  shame  when  told  about  them. 

Thereafter  there  were  abortive  attacks,  which  entirely  disappeared, 
to  give  place  to  the  normal  mental  condition  in  June. 

In  a  case  reported  by  Gock  (Arch.  f.  Psych.,  v),  which  was 
probably  circular  insanity,  in  a  man  of  very  bad  heredity,  during 
the  stage  of  exaltation  there  was  manifestation  of  sexual  feeling 
for  men.  In  this  case,  however,  the  patient  thought  himself  a 
girl,  and  it  is  questionable  whether  the  sexual  inclination  was 
induced  by  the  delusion  or  by  a  contrary  sexual  instinct. 

In  connection  with  these  cases  of  abnormal  manifestation 
of  the  sexual  instinct  are  those  which,  as  a  symptom  of  mania, 
manifest  an  abnormal  and  frequently  a  perverse  sexual  instinct  in 
an  impulsive  way,  analogous  to  dipsomania,  which  forms  the 
nucleus  of  the  psychical  disturbance,  while  in  the  intervals  the 
sexual  instinct  is  neither  intense  nor  perverse. 


PERIODICAL   INSANITY.  371 

Quite  a  pure  case  of  such  periodical  psychopathia  sexualis, 
connected  with  the  process  of  menstruation,  is  the  following, 
reported  by  Anjel  {Arch.  f.  Psych.,  xv,  H.  2) : — 

Case  162.  A  quiet  lady,  near  the  climacteric.  Very  bad  heredity. 
In  her  youth,  attacks  of  petit  mal.  Always  eccentric,  quick-tempered  ; 
very  moral ;  childless  marriage. 

Several  years  ago,  after  a  violent  emotional  disturbance,  a  hystero- 
epileptic  attack,  with  post-epileptic  insanity  of  several  weeks'  duration. 
Thereafter  there  was  sleeplessness  for  several  months.  Following  this, 
there  was  always  menstrual  insomnia,  and  the  impulse  to  embrace  and 
kiss  boys  of  ten,  and  fondle  their  genitals.  During  this  excitement  there 
was  no  desire  for  coitus  ;  certainly  not  for  intercourse  with  adults. 

The  patient  often  speaks  openly  of  this  impulse,  and  asks  to  be 
watched,  as  she  is  not  to  be  trusted.  In  the  intervals  she  anxiously 
avoids  all  talk  of  it,  is  very  modest,  and  in  nowise  passionate  sexually. 

With  reference  to  the  still  imperfectly-known  cases  of  periodical 
psychopathia  sexualis  of  this  kind,  Tarnowsky  (op.  cit.,  p.  38)  has  made 
valuable  contributions,  though  his  cases  were  not  all  of  a  periodic 
nature;  and  one  of  the  cases,  taken  from  a  work  of  the  author's,  is  not 
rightly  understood  (Case  8,  p.  37),  since  sodomy  was  only  subsidiary, 
and  the  abnormal  intense  libido  sexualis  was  not  periodic. 

Tarnowsky  reports  cases  where  married,  cultured  men,  the  fathers 
of  families,  were,  from  time  to  time,  compelled  to  perform  the  most 
terrible  sexual  acts,  while  during  the  intervals  they  were  sexually  nor- 
mal, abhorred  their  paroxysmal  sexual  acts,  and  shuddered  before  the 
expectation  of  their  repetition. 

If  a  new  paroxysm  came  on,  the  normal  sexual  instinct  disap- 
peared; a  state  of  mental  excitement  arose  with  insomnia,  and  thoughts 
and  impulses  to  commit  the  perverse  sexual  acts,  with  anxious  confusion 
and  an  increasing  impulse  to  the  abhorred  indulgence.  In  this  state  the 
act  was  a  relief,  because  it  ended  the  condition.  The  analogy  with 
dipsomania  is  complete. 

For  other  cases  (of  periodical  pederasty),  vide  Tarnowsky, 
op.  cit.,  p.  41.  The  case  there  reported,  on  page  46,  belongs 
in  the  category  of  epilepsy. 

The  following  case,  reported  by  Anjel  (Arch.  f.  Psych., 
xv,  II.  2),  is  one  of  the  most  typical  of  the  convulsive-like 
occurrence  of  sexual  excitement : — 

Case  163.  A  gentleman  of  high  social  position,  aged  45;  generally 
respected  and  beloved ;  heredity  good ;  very  moral ;  married  fifteen 
years.     Previously  normal  sexually ;  the  father  of  several  healthy  chil- 


372  PSYCHOPATHIA   SEXUALIS. 

dren,  and  living  in  happy  matrimony.  Eight  years  ago  he  suffered  a 
violent  fright.  For  some  weeks  thereafter  he  had  a  feeling  of  apprehen- 
sion and  cardiac  attacks.  Then  came  attacks,  at  intervals  of  several 
months  or  a  year,  of  what  the  patient  called  his  "  moral  catarrh."  He 
became  sleepless.  After  three  days,  loss  of  appetite,  increasing  irrita- 
bility, strange  appearance;  fixed  stare,  staring  into  space;  paleness, 
changing  with  redness;  tremor  of  the  fingers;  red,  shining  eyes,  with 
peculiar  glass}'  expression  ;  and  violent,  quick  manner  of  speech.  There 
was  a  desire  for  girls  of  from  five  to  ten  years,  even  for  his  own 
daughters.  He  would  beg  his  wife  to  guard  the  children.  For  days  at  a 
time,  while  in  this  state,  he  would  shut  himself  in  his  room.  Previously 
he  was  compelled  to  pass  school-girls  on  the  street,  and  he  found  a 
peculiar  pleasure  in  exposing  his  genitals  before  them,  by  acting  as  if 
about  to  urinate. 

For  fear  of  exposure,  he  shuts  himself  in  his  room,  full  of  desire, 
incapable  of  movement,  and  torn  by  feelings  of  fear.  Consciousness 
seems  to  be  undisturbed.  The  attacks  last  from  eight  to  fourteen  days. 
The  cause  of  their  return  is  not  clear.  Improvement  is  sudden ;  there 
is  great  desire  for  sleep,  and,  after  this  is  satisfied,  he  is  again  well.  In 
the  interval  there  is  nothing  abnormal.  The  author  assumes  an  epileptic 
foundation,  and  considers  the  attacks  to  be  the  psychical  equivalents  of 
epileptic  convulsions  (!). 

Mania. — With  the  general  excitation  that  here  exists  in 
the  psychical  organ,  the  sexual  sphere  is  likewise  often  impli- 
cated. In  maniacal  individuals  of  the  female  sex,  this  is  the 
rule.  In  certain  cases,  it  may  be  questionable  whether  the 
instinct,  which,  in  itself,  is  not  intensified,  is  simply  recklessly 
manifested,  or  whether  it  is  present  in  actual  abnormal  inten- 
sity. For  the  most  part,  the  latter  is  the  true  assumption, — 
certainly  so  where  sexual  delusions  and  their  religious  equiva- 
lents are  constantly  expressed.  In  accordance  with  the  degrees 
of  intensity  of  the  disease,  the  intensified  instinct  is  expressed 
in  different  forms. 

In  simple  maniacal  exaltation  in  men,  courting,  frivolity, 
and  lasciviousness  in  speech,  and  frequenting  of  brothels,  are 
observed ;  in  women,  inclination  for  the  society  of  men,  per- 
sonal adornment,  perfumes,  talk  of  marriage  and  scandals, 
suspicion  of  the  virtue  of  other  women;  or  there  is  mani- 
fested the  religious  equivalent, — pilgrimages,  missionary  work, 
desire  to  go  into  a   cloister  or   to  become  the   servant   of  a 


SATYRIASIS  AND  NYMPHOMANIA.  373 

priest ;  and  in  this  case  there  is  much  talk  about  innocence  and 
virginity. 

At  the  height  of  mania  there  may  be  seen  invitations  to 
coitus,  exhibition,  obscenity,  great  excitation  at  sight  of  women, 
tendency  to  smear  the  person  with  saliva,  urine,  and  even  faeces ; 
religio-sexual  delusions, — to  be  under  the  protection  of  the 
Holy  Ghost,  to  have  given  birth  to  Christ,  etc. ;  open  onanism, 
and  pelvic  movements  of  coitus. 

In  maniacal  men  care  must  be  taken  to  prevent  shameless 
masturbation  and  sexual  attacks  on  women. 

Satyriasis  and  Nymphomania. 

States  of  mental  excitement,  in  which  an  abnormal  intense 
sexual  impulse  is  prominent,  are  called  satyriasis  (in  males)  and 
nymphomania  (in  women),  or  uteromania. 

Moreau  considers  these  cases  peculiar  to  themselves,  but 
he  is  certainly  in  error.  The  sexual  complexus  of  symptoms  is 
always  but  the  partial  manifestation  of  a  general  psychosis 
(mania,  hallucinatory  insanity'?). 

The  essential  element  of  the  state  of  sexual  excitement  is 
a  condition  of  psychical  hyperesthesia  with  involvement  of  the 
sexual  sphere.  The  imagination  calls  up  only  sexual  images, 
which  may  lead  to  hallucinations,  illusions,  and  true  hallucina- 
tory delirium. 

The  most  indifferent  ideas  excite  sensual  association,  and 
the  lustful  coloring  of  the  ideas  and  apperceptions  is  very  much 
intensified. 

The  abnormal  state  of  consciousness  implicates  the  whole 
course  of  feeling  and  desire,  and  is  accompanied  by  general 
physical  excitement  like  that  that  accompanies  coitus  (v. 
"Physiology").  Often  the  genitals  are  in  a  constant  state  of 
turgor  (priapism  in  males). 

The  man  affected  with  this  sexual  passion  seeks  to  satisfy 
his  desire  at  any  price,  and,  therefore,  becomes  very  dangerous 
to  women.  Faute  de  mieux,  he  practices  onanism  or  sodomy. 
The  nymphomaniacal  woman  seeks  men  by  exhibition,  or  to 
attract  them  by  her  sensual  conduct ;  at  the  sight  of  men  she  is 


374  PSYCHOPATHIA  SEXUALIS. 

intensely  excited  sexually,  and  satisfies  herself  by  masturbation, 
or  by  pelvic  movements  of  coitus. 

Satyriasis  is  infrequent.  Nymphomania  is  more  frequently 
observed,  and  not  seldom  in  the  climacteric.  It  may  occur  in 
senility.  Abstinence, *  with  constant  excitation  of  the  sexual 
sphere  as  a  result  of  psychical  or  peripheral  irritation  (pruritus 
pudendi,  oxyuris,  etc.),  may  cause  these  conditions,  but  probably 
only  in  those  predisposed. 

The  assertion  that  it  may  also  result  from  poisoning  by 
cantharides  seems  to  depend  upon  confounding  it  with  priapism. 
The  primary  lustful  feeling  that  accompanies  priapism  due  to 
cantharides  soon  becomes  painful.  Satyriasis  and  nympho- 
mania are  acute  abnormal  psycho-sexual  states. 

There  are  also  cases  that,  not  without  reason,  might  be 
called  chronic  satyriasis  or  nymphomania.  To  these  belong 
the  men  who,  for  the  most  part  as  a  result  of  abusus  veneris, 
or  more  particularly  of  masturbation,  suffer  with  neurasthenia 
sexualis,  and  at  the  same  time  have  intense  libido  sexualis. 
The  imagination,  as  in  acute  cases,  is  in  a  state  of  excitement, 
and  the  mind  full  of  obscene  images;  so  that  the  most  ele- 
vated ideas  are  besmirched  with  the  most  cynical  images  and 
thoughts. 

The  thought  and  desire  of  such  men  are  solely  directed  to 
the  sexual  sphere ;  and  since  their  flesh  is  weak,  led  on  by  their 
fancy,  they  come  to  indulge  in  the  grossest  perversions  of  the 
sexual  act. 

Analogous  cases  in  women  may  be  called  chronic  nympho- 
mania. -  They  naturally  lead  to  prostitution.  Legrand  du 
Saulle  ("  La  folie,"  p.  510)  reports  interesting  cases  which 
apparently  are  pure. 

Melancholia. — The  thoughts  and  feelings  of  melancholiacs 
are  not  favorable  for  the  excitation  of  sexual  desires.  At  the 
same  time,  these  patients  sometimes  masturbate.  In  my  experi- 
ence such  cases  have  always  been  hereditarily  predisposed  and 
previously  given  to  onanism.     The  act  did  not  seem  to  be  so 

1  Comp.  the  interesting  cases  of  Marc-Ideler,  ii,  p.  137. — Ideler,  "  Grundriss  der 
Seelenheilkunde,"  ii,  pp.  488-493. 


HYSTERIA.  375 

much  due  to  a  lustful  desire  as  to  be  induced  by  habit,  ennui, 
anxiety,  and  the  impulse  to  change  temporarily  the  painful 
mental  condition. 

Hysteria. — In  this  neurosis  the  sexual  life  is  very  frequently 
abnormal ;  indeed,  always  in  predisposed  individuals.  All  the 
possible  anomalies  of  the  sexual  function  may  occur  here,  with 
sudden  changes  and  peculiar  activity;  and,  on  an  hereditary 
degenerate  basis  and  in  moral  imbecility,  they  may  appear  in 
the  most  perverse  forms.  The  abnormal  change  and  inversion 
of  the  sexual  feeling  are  never  without  effect  upon  the  patient's 
disposition. 

The  following  case,  reported  by  Giraud,  is  one  of  this 
nature  worthy  of  repetition : — 

Case  164.  Marian  L.,  of  Bordeaux.  At  night,  while  the  household 
was  asleep  under  the  influence  of  narcotics  she  had  administered,  she 
had  given  the  children  of  the  house  to  her  lover  for  sexual  enjoyment, 
and  had  looked  on  at  the  immoral  acts.  It  was  found  that  L.  was  hys- 
terical (hemianesthesia  and  convulsive  attacks),  but  before  her  illness 
she  had  been  a  moral,  trustworthy  person.  Since  her  illness  she  had 
become  a  shameless  prostitute,  and  lost  all  moral  sense. 

In  the  hysterical  the  sexual  sphere  is  often  abnormally 
excited.  This  excitement  may  be  intermittent  (menstrual1?). 
Shameless  prostitution,  even  in  married  women,  may  result.  In 
a  milder  form  the  sexual  impulse  expresses  itself  in  onanism, 
going  about  in  a  room  naked,  smearing  the  person  with  urine 
and  other  things,  or  wearing  male  attire,  etc. 

Schule  {Klin.  Psychiatrie,  1886,  p.  237)  finds  very  fre- 
quently an  abnormally  intense  sexual  impulse  "  which  disposes 
girls,  and  even  women  living  in  happy  marriage,  to  become 
Messalinas." 

The  author  cited  knows  cases  in  which,  on  the  wed- 
ding-journey, attempts  at  flight  with  men,  who  had  been 
accidentally  met,  were  made;  and  respected  wives  who  en- 
tered into  liaisons,  and  sacrificed  everything  to  their  insatiable 
impulse. 

In  hysterical  insanity  the  abnormally  intense  sexual  im- 
pulse may  express  itself  in  delusions  of  jealousy,  unfounded 


376  PSYCHOPATHIA   SEXUALIS. 

accusations  against  men  for  immoral  acts,1  hallucinations  of 
coitus,2  etc. 

Occasionally  frigidity  may  occur,  with  absence  of  lustful 
feeling, — due,  for  the  most  part,  to  genital  anaesthesia. 

Paranoia. — Abnormal  manifestations  in  the  sexual  sphere, 
in  the  various  forms  of  paranoia,  are  not  infrequent.  Many  of 
these  cases  are  developed  on  sexual  abuse  (masturbatic  para- 
noia) or  sexual  excitement;  and,  according  to  experience,  in 
individuals  psychically  degenerate,  with  other  functional  signs 
of  degeneracy,  the  sexual  sphere  is,  for  the  most  part,  deeply 
implicated. 

In  paranoia  religiosa  and  erotica  the  abnormally  intense 
and,  under  certain  circumstances,  perverse  sexual  instinct  is 
most  clearly  manifested.  In  the  first  variety,  however,  the 
condition  of  sexual  excitation  is  expressed  not  so  much  in  a 
direct  method  of  satisfaction  of  the  sexual  desires  as  (there  are 
exceptions)  in  platonic  love, — in  enthusiastic  admiration  of  a 
person  of  the  opposite  sex  who  is  pleasing  aesthetically.  Under 
certain  circumstances,  the  enthusiasm  is  for  a  fanciful  person,  a 
portrait,  or  a  statue. 

A  love  for  the  opposite  sex  that  is  weak  and  purely  mental, 
too,  often  has  its  basis  in  weakness  of  the  genitals  due  to  long- 
continued  masturbation  ;  and,  under  the  guise  of  virtuous  admi- 
ration of  a  beloved  person,  great  lasciviousness  and  sexual  per- 
version are  often  concealed.  Episodically,  especially  in  women, 
violent  sexual  excitement  may  occur  as  a  nymphomania. 

For  the  most  part,  paranoia  religiosa  rests  upon  sexuality 
which  manifests  itself  in  a  sexual  impulse  that  is  abnormally 
early  and  intense.  The  libido  finds  satisfaction  in  masturba- 
tion or  religious  enthusiasm,  the  object  of  which  may  be  a 
certain  minister,  saint,  etc. 

The  psycho-pathological  relations  between  the  sexual  and 
religious  domains  have  been  described  in  detail  on  p.  8  et  seq. 


1  Vide  Fall  Merlac,  in  the  author's  Lehrh.  d.  ger.  Psychopathol.,  2  Aufl.,  p.  322. — 
Morel,  Traite  des  malad.  mentales,  p.  687. — Legrand,  La  folie,  p.  337. — Process  La  Ronciere, 
in  Annal.  d'hyg.,  1.  Serie,  iv ;  3.  Serie,  xxii. 

3  The  incubus  in  the  witch-trials  of  the  Middle  Ages  depended  on  them. 


PARANOIA.  377 

Apart  from  masturbation,  sexual  crimes  are  relatively  fre- 
quent in  religious  paranoia. 

Marc's  work  (p.  160)  contains  a  remarkable  example  of 
religious  insanity. 

Giraud  (Annal.  lined,  psychol.)  has  reported  a  case  of  rape 
of  a  little  girl  by  a  religious  paranoiac,  aged  43,  who  was  tem- 
porarily erotic.  Here,  also,  belongs  a  case  of  incest  (Liman, 
Vierteljalirsschr.  f.  ger.  Med.). 

Case  165.  M.  impregnated  his  daughter.  His  wife,  mother  of  eight- 
een children,  and  herself  pregnant  by  her  husband,  lodged  the  complaint. 
M.  had  had  religious  paranoia  for  two  years.  "  It  was  revealed  to  me 
that  I  should  beget  the  Eternal  Son  with  my  daughter.  Then  a  man  of 
flesh  and  blood  would  arise  by  my  faith,  who  would  be  eighteen  hundred 
years  old.  He  would  be  a  bridge  between  the  Old  and  New  Testaments." 
This  command,  which  he  deemed  divine,  was  the  cause  of  his  insane  act. 

Sexual  acts  that  have  a  pathological  motive  sometimes 
occur  in  persecutory  paranoia. 

Case  166.  A  married  woman  of  thirty  had,  by  means  of  money  and 
sweetmeats,  enticed  a  boy  of  five,  who  plaj-ed  near  her,  handled  his  gen- 
itals, and  then  attempted  coitus.  She  was  a  teacher,  who  had  been 
betrayed  and  then  cast  off.  Previously  moral,  for  some  time  she  had 
given  herself  to  prostitution.  The  explanation  of  her  immoral  change 
was  given,  when  it  was  found  that  she  had  various  delusions  of  persecu- 
tion, and  thought  she  was  under  the  secret  influence  of  her  seducer,  who 
impelled  her  to  sexual  acts.  She  also  believed  that  the  boy  had  been 
put  in  her  way  bjr  her  seducer.  Coarse  sensuality  as  a  motive  for  her 
crime  came  less  into  consideration,  as  it  would  have  been  easy  for  her  to 
satisfy  sexual  desire  in  a  natural  way.  (Kiissner,  Berl.  klin.  Wochen- 
schrift.) 

Cullerre  ("Perversions  sexuelles  chez  les  persecutes,"  in 
Annal.  rnedico-psychol.,  March,  1886)  has  reported  similar 
cases, — the  case  of  a  patient  who,  suffering  with  paranoia  sex- 
ualis  persecutoria,  tried  to  violate  his  sister,  giving  as  a  reason 
that  the  impulse  was  given  him  by  Bonapartists. 

In  another  case  a  captain,  suffering  with  delusions  of  per- 
secution by  electro-magnetism,  was  driven  to  pederasty, — a  thing 
he  abhorred.  In  a  similar  case  the  persecutor  impelled  to 
onanism  and  pederasty. 


V.    PATHOLOGICAL  SEXUALITY  IN  ITS 
LEGAL  ASPECTS. 


The  laws  of  all  civilized  nations  punish  those  who  commit 
perverse  sexual  acts.  Inasmuch  as  the  preservation  of  chastity 
and  morals  is  one  of  the  most  important  reasons  for  the  exist- 
ence of  the  commonwealth,  the  state  cannot  be  too  careful,  as  a 
protector  of  morality,  in  the  struggle  against  sensuality.  This 
contest  is  unequal ;  because  only  a  certain  number  of  the  sexual 
crimes  can  be  legally  combated,  and  the  infractions  of  the  laws 
by  so  powerful  a  natural  instinct  can  be  but  little  influenced  by 
punishment.  It  also  lies  in  the  nature  of  the  sexual  crimes, 
that  but  a  part  of  them  ever  reach  the  knowledge  of  the 
authorities.  Public  sentiment,  in  that  it  looks  upon  them  as 
disgraceful,  lends  much  aid. 

Criminal  statistics  prove  the  sad  fact  that  sexual  crimes 
are  progressively  increasing  in  our  modern  civilization. x  This 
is  particularly  the  case  with  immoral  acts  with  children  under 
the  age  of  fourteen.  The  moralist  sees  in  these  sad  facts 
nothing  but  the  decay  of  general  morality,  and  in  some  instances 
comes  to  the  conclusion  that  the  present  mildness  of  the  laws 
punishing  sexual  crimes,  in  comparison  with  their  severity  in 
past  centuries,  is  in  part  responsible  for  this. 

The  medical  investigator  is  driven  to  the  conclusion  that 
this  manifestation  of  modern  social  life  stands  in  relation  to  the 
predominating  nervousness  of  later  generations,  in  that  it  begets 
defective  individuals,  excites  the  sexual  instinct,  leads  to  sexual 
abuse,  and,  with  continuance  of  lasciviousness  associated  with 
diminished  sexual  power,  induces  perverse  sexual  acts. 

It  will  be  clearly  seen,  from  what  follows,  how  such  an 
opinion  is  justified,  especially  with   respect  of  the  increasing 

1  Comp.  Casper,  Klin.  Novellen. — Lombroso,  Goltdammer's  Archiv,  Bd.  xxx. — 
Oettingen,  Moraletatistik,  p.  494. 

(378) 


SEXUAL   CRIMES.  379 

number  of  sexual  crimes  committed  on  children.  It  is  at  once 
evident,  from  what  has  gone  before,  that  neuropathic,  and 
even  psychopathic,  states  are  largely  determinate  for  the  com- 
mission of  sexual  crimes.  Here  nothing  less  than  the  respon- 
sibility of  many  of  the  men  who  commit  such  crimes  is  called 
in  question. 

Psychiatry  cannot  be  denied  the  credit  of  having  recognized 
and  proved  the  psycho-pathological  significance  of  numerous 
monstrous,  paradoxical  sexual  acts.  Law  and  Jurisprudence 
have  thus  far  given  but  little  attention  to  the  facts  resulting  from 
investigations  in  psychopathology.  Law  is,  in  this,  opposed  to 
Medicine,  and  is  constantly  in  danger  of  passing  judgment  on 
individuals  who,  in  the  light  of  science,  are  not  responsible  for 
their  acts. 

Owing  to  this  superficial  treatment  of  acts  that  deeply  con- 
cern the  interests  and  welfare  of  society,  it  becomes  very  easy 
for  justice  to  treat  a  delinquent,  who  is  as  dangerous  to  society 
as  a  murderer  or  a  wild  beast,  as  a  criminal,  and,  after  punish- 
ment, release  him  to  prey  on  society  again ;  on  the  other  hand, 
scientific  investigation  shows  that  a  man  mentally  and  sexually 
degenerate  ah  origine,  and  therefore  irresponsible,  must  be  re- 
moved from  society  for  life,  but  not  as  a  punishment. 

A  judge  who  considers  only  the  crime,  and  not  its  perpe- 
trator, is  always  in  danger  of  injuring  not  only  important  inter- 
ests of  society  (general  morality  and  safety),  but  also  those  of 
the  individual  (honor). 

In  no  domain  of  criminal  law  is  co-operation  of  judge  and 
medical  expert  so  much  to  be  desired  as  in  that  of  sexual  delin- 
quencies ;  and  here  only  anthropological  and  clinical  investiga- 
tion can  afford  light  and  knowledge.  The  nature  of  the  act  can 
never,  in  itself,  determine  a  decision  as  to  whether  it  lies  within 
the  limits  of  mental  pathology,  or  within  the  bounds  of  mental 
physiology.  The  perverse  act  does  not  indicate  perversion  of 
instinct.  At  any  rate,  the  most  monstrous  and  perverse  sexual 
acts  have  been  committed  by  persons  of  sound  mind.  The 
perversion  of  feeling  must  be  shown  to  be  pathological.  This 
proof  is  to  be  obtained  by  learning  the  conditions  attending  its 


380      "  PSYCHOPATHIA   SEXtJALlS. 

development,  and  by  proving  the  existence  of  a  general  neuro- 
pathic or  psychopathic  condition. 

The  species  facti  is  important;  but  it  allows,  however,  only 
presumptions,  since  the  same  sexual  act,  according  as  it  is  com- 
mitted by  an  epileptic,  paralytic,  or  a  man  of  sound  mind,  takes 
on  other  features  and  peculiarities,  in  accordance  with  the 
manner  in  which  it  is  done. 

Periodical  recurrence  of  the  act  under  identical  circum- 
stances, and  an  impulsive  manner  in  carrying  it  out,  give  rise  to 
weighty  presumptions  that  it  is  of  pathological  significance. 
The  decision,  however,  must  follow  after  referring  the  act  to  its 
psychological  motive  (abnormalities  of  thought  and  feeling), 
and  after  showing  this  elementary  anomaly  to  be  but  one  symp- 
tom of  a  general  neuropathic  condition, — either  an  arrest  of 
mental  development,  or  a  condition  of  psychical  degeneration, 
or  a  psychosis. 

The  cases  discussed  in  the  portion  of  this  work  devoted  to 
general  and  special  pathology  will  certainly  be  useful  to  the 
medical  expert,  in  assisting  him  to  discover  the  motive  of  the 
act.  To  obtain  the  facts  necessary  to  allow  a  decision  of  the 
question  whether  immorality  or  abnormality  occasioned  the  act, 
a  medico-legal  examination  is  required, — an  examination  which 
is  made  according  to  the  rules  of  science ;  which  takes  account 
of  both  the  past  history  of  the  individual  and  the  present  con- 
dition,— the  anthropological  and  clinical  data. 

The  proof  of  the  existence  of  an  original,  congenital  anomaly 
of  the  sexual  sphere  is  important,  and  points  to  the  need  of  an 
examination  in  the  direction  of  a  condition  of  psychical  degen- 
eration. An  acquired  perversity,  to  be  pathological,  must  be 
found  to  depend  upon  a  neuropathic  or  psychopathic  state. 

Practically,  paretic  dementia  and  epilepsy  must  first  come 
to  mind.  The  decision  concerning  responsibility  will  depend  on 
the  demonstration  of  the  existence  of  a  psychopathic  state  in 
the  individual  convicted  of  a  sexual  crime. 

This  is  indispensable,  to  avoid  the  danger  of  covering 
simple  immorality  with  the  cloak  of  disease. 

Psychopathic  states  may  lead  to  crimes  against  morality, 


SEXUAL   CRIMES.  381 

and  at  the  same  time  remove  the  conditions  necessary  to  the 
existence  of  responsibility,  under  the  following  circumstances : — 

1.  To  oppose  the  normal  or  intensified  sexual  desire,  there 
may  be  no  moral  or  legal  notions,  owing  to  (a)  the  fact  that 
they  may  never  have  been  developed  (states  of  congenital  men- 
tal weakness) ;  or  to  (b)  the  fact  that  they  have  been  lost  (states 
of  acquired  mental  weakness). 

2.  When  the  sexual  desire  is  increased  (states  of  psychical 
exaltation)  and  consciousness  simultaneously  clouded,  the  men- 
tal mechanism  is  too  much  disturbed  to  allow  the  opposing 
ideas,  virtually  present,  to  exert  their  influence. 

3.  When  the  sexual  instinct  is  perverse  (states  of  psychical 
degeneration).     It  may,  at  the  same  time,  be  intensified. 

Cases  of  sexual  delinquency  that  occur  outside  of  states  of 
mental  defect,  degeneration,  or  disease,  can  never  be  excused  on 
the  ground  of  irresponsibility. 

In  many  cases,  instead  of  an  abnormal  psychical  condition, 
a  neurosis  (local  or  general)  is  found.  Inasmuch  as  the  transi- 
tions from  a  neurosis  to  a  psychosis  are  easy,  and  elementary 
psychical  disturbances  are  frequent  in  the  former,  and  constant 
in  profound  perversion  of  the  sexual  life,  the  neurotic  affection 
— e.g.,  impotence,  irritable  weakness,  etc. — exerts  an  influence 
on  the  motive  of  the  incriminating  act ;  and  a  just  judge,  not- 
withstanding the  lack  of  legal  irresponsibility  due  to  mental  de- 
fect or  disease,  will  recognize  the  circumstances  which  ameliorate 
the  heinousness  of  the  crime. 

For  various  reasons  the  practical  jurist  will,  in  all  cases  of 
sexual  crimes,  call  medical  experts  to  make  a  psychiatric  exam- 
ination. 

To  be  sure,  his  own  conscience  and  judgment  must  be  the 
guides  when  necessity  makes  them  his  only  reliance.  Under 
the  following  circumstances  indices  are  given  which  point  to  a 
pathological  condition : — 

The  accused  is  senile.  The  sexual  crime  is  committed 
openly,  with  remarkable  cynicism.  The  manner  of  obtaining 
sexual  satisfaction  is  silly  (exhibition),  or  cruel  (mutilation  or 
murder),  or  perverse  (necrophilia,  etc.). 


382  PSYCHOPATHIA   SEXUALIS. 

From  what  experience  teaches,  it  may  be  said  that,  among 
the  sexual  acts  that  occur,  rape,  mutilation,  pederasty,  amor 
lesbicus,  and  bestiality  may  have  a  psycho-pathological  basis. 

In  case  of  lust-murder, — in  as  far  as  it  goes  beyond  murder 
itself, — and  likewise  in  case  of  mutilation  of  corpses,  psycho- 
pathic conditions  are  probable. 

Exhibition  and  mutual  masturbation  make  pathological 
states  seem  very  probable.  Masturbation  of  another  and  passive 
onanism  may  occur  in  connection  with  senile  dementia  and 
contrary  sexual  feeling,  but  also  with  mere  sensuality.  . 

Cunnilingus  and  fellare  (penem  in  os  mulieris  arrigere) 
have  not  thus  far  been  shown  to  depend  upon  psycho-patho- 
logical conditions. 

These  horrible  sexual  acts  seem  to  be  committed  only  by 
sensual  men  who  have  become  satiated  or  impotent  from  exces- 
sive indulgence  in  a  normal  way.  Paedicatio  mulierum  does 
not  seem  to  be  psychopathic,  but  rather  a  practice  of  married 
men  of  low  morality,  who  wish  to  prevent  pregnancy ;  and  of 
satiated  cynics  in  non-marital  sexual  indulgence. 

The  practical  importance  of  the  subject  makes  it  necessary 
that  the  sexual  acts  threatened  with  punishment  as  sexual 
crimes  be  considered  by  jurists  from  the  stand-point  of  the 
medico-legal  expert.  Thus  there  is  an  advantage  gained,  in 
that  the  psycho-pathological  acts,  according  to  circumstances, 
are  placed  in  the  right  light  by  comparison  with  analogous  acts 
that  fall  within  the  domain  of  physiological  psychology. 

1.    Offense  Against  Morality  in  the  Form  of  Exhibition. 
(Austrian  Statutes,  §  516;  Abridgment,  §  195.    German  Statutes,  §  183.) 

In  man's  present  condition  of  civilization,  modesty  is  a 
characteristic  and  motive  so  firmly  fixed  by  centuries  of  educa- 
tion that  presumption  of  a  psycho-pathologicaf  element  neces- 
sarily arises  when  public  decency  is  coarsely  offended. 

The  presumption  is  justifiable  that  an  individual  who  in 
this  way  has  offended  public  decency  and  his  own  self-respect 
was  incapable  of  moral  feeling  (idiots) ;  or  that  it  has  been  lost 


EXHIBITION.  383 

(states  of  acquired  mental  weakness) ;  or  that  he  has  acted 
while  in  a  clouded  state  of  consciousness  (transitory  insanity, 
states  of  partial  consciousness). 

A  very  distinctive  act  which  belongs  here  is  that  of 
exhibition  (exposure).  The  cases  thus  far  recorded  are  exclu- 
sively those  of  men  who  ostentatiously  expose  their  genitals  to 
persons  of  the  opposite  sex,  in  some  instances  following  them, 
without,  however,  becoming  aggressive. 

The  silly  manner  of  this  sexual  activity,  or  really  sexual 
demonstration,  points  to  intellectual  and  moral  weakness;  or,  at 
least,  to  temporary  inhibition  of  the  intellectual  and  moral  func- 
tions, with  excitation  of  libido  dependent  upon  a  decided  dis- 
turbance of  consciousness  (abnormal  unconsciousness,  mental 
confusion) ;  and,  at  the  same  time,  the  virility  of  these  individ- 
uals is  called  in  question.  Thus  there  are  various  categories 
of  exhibitionists. 

The  first  category  includes  states  of  mental  weakness  in 
which,  owing  to  the  causative  cerebral  (or  spinal)  disease,  con- 
sciousness is  clouded,  and  the  ethical  and  intellectual  functions 
are  interfered  with ;  and  in  which  there  can  be  no  opposition 
made  to  a  sexual  desire  that  has  either  always  been  intense,  or 
that  has  been  intensified  by  the  disease-process.  At  the  same 
time,  impotence  exists,  and  no  longer  permits  expression  of 
the  sexual  instinct  in  violent  acts  (rape),  but  only  in  acts  that 
are  silly. 

The  majority  of  reported  cases !  fall  in  this  category.  They 
are  those  of  individuals  afflicted  with  senile  dementia,  paretic 
dementia,  or  mental  defects  due  to  alcoholism,  epilepsy,  etc. 

Case  167.  Z.,  high  official,  aged  60;  widower;  father  of  a  family. 
He  had  excited  offense  in  that,  during  fourteen  days,  he  had  repeatedly 
exposed  his  genitals  at  his  window,  to  a  girl  of  eight  years  who  lived 
opposite  him.  After  a  few  months,  under  like  circumstances,  this  man 
repeated  his  indecent  act.  At  his  examination  he  acknowledged  the 
depravity  of  his  action,  and  could  give  no  excuse  for  it.  Death,  a  year 
later,  due  to  cerebral  disease.     (Lasegue,  op.  cit.) 


1  Lasegue,  Union  Medicale,  1877,  May. — Laugier,  Annal  d'hygiene  publ.,  1878,  No. 
106.— Pelanda,  "Pornopaths,"  Archivio  di  Psictaiatria,  viii.— Schuchardt,  Zeitschr.  f.  Medi- 
cinalbeamte,  1890,  Heft  6. 


384  PSYCHOPATHIA   SEXUAUS. 

Case  168.  Z.,  aged  78;  seaman.  He  had  repeatedly  exhibited  his 
genitals  on  children's  play-grounds,  and  in  the  neighborhood  of  girls' 
schools.  This  was  the  only  way  in  which  he  was  active  sexually.  He 
was  married,  and  the  father  of  ten  children.  Twelve  years  before,  he 
had  suffered  a  severe  head-injury,  since  which  he  had  had  a  deep  scar, 
which  indented  the  bone.  Pressure  on  this  scar  caused  pain ;  at  the 
same  time  his  face  would  flush,  his  expression  become  fixed,  and  he 
would  grow  somnolent,  with  convulsive  movements  in  the  right  upper 
extremity  (apparently  epileptoid  state  in  connection  with  cortical  dis- 
ease). Besides,  there  was  senile  dementia  and  advanced  senium.  It  is 
not  reported  whether  the  exhibition  coincided  with  epileptoid  attacks  or 
not.     Senile  dementia  proved  ;  pardoned.     (Dr.  Schuchardt,  op.  cit.) 

Pelanda  {op.  cit.)  has  reported  a  number  of  cases  of  this 
kind : — 

1.  Paralytic,  aged  60.  At  the  age  of  fifty-eight  he  began  to  exhibit 
himself  to  women  and  children.  In  the  asylum  at  Verona,  for  a  long 
time  thereafter,  he  was  lascivious  and  also  attempted  fellatio.    . 

2.  A  drinker,  aged  66,  suffering  with  folie  circulaire.  His  exhibition 
was  first  noticed  in  church  during  divine  service.  His  brother  was  like- 
wise an  exhibitionist. 

3.  A  drinker,  predisposed,  aged  49.  He  was  always  very  excitable 
sexually ;  in  an  asylum  on  account  of  chronic  alcoholism.  He  exhibited 
himself  whenever  he  saw  a  woman. 

4.  A  man,  aged  64 ;  married  ;  father  of  fourteen  children.  Great 
predisposition.  Rachitic,  microcephalic  head.  For  years  he  had  been 
an  exhibitionist,  in  spite  of  repeated  punishment. 

Case  169.  X.,  merchant,  born  in  1833;  single.  He  had  repeatedly 
exhibited  himself  to  children,  or  even  urinated  at  the  same  time ;  once, 
under  these  circumstances,  he  had  kissed  a  little  girl,  driving  her  away. 
Twenty  years  previously  X.  had  had  a  severe  attack  of  mental  disease, 
lasting  two  years,  in  which  he  is  said  to  have  had  an  apoplectic  attack. 
Later,  after  loss  of  his  fortune,  he  gave  himself  to  drink,  and  of  late  years 
had  often  appeared  absent-minded.  His  condition  was  that  of  alcoholism, 
senium  prsecox,  and  mental  weakness.  Penis  small ;  phimosis ;  testicles 
atrophic.    Proof  of  mental  disease ;  pardoned.    (Dr.  Schuchardt,  op.  cit.) 

Such  cases  recall  the  lasciviousness  of  youthful,  sexually- 
excited  persons  that  are  still  more  or  less  boyish;  but  also  that 
of  many  mature  cynics  of  low  morality,  who  find  pleasure  in  de- 
filing the  walls  of  public  closets,  etc.,  with  drawings  of  male  and 
female  genitals, — a  kind  of  ideal  exhibition  which,  however,  is 
still  widely  separated  from  actual  exhibition. 


EXHIBITION.  385 

Another  category  of  exhibitionists  is  made  up  of  epileptics. 
This  category  is  essentially  to  be  distinguished  from  the  fore- 
going, in  that  a  conscious  motive  for  the  exhibition  is  wanting ; 
and  it  appears  much  more  like  an  impulsive  act  which,  without 
any  consideration  of  external  circumstances,  is  performed  as  if 
it  were  an  abnormal  organic  necessity. 

At  the  time  of  the  act  there  is  always  a  state  of  imperfect 
consciousness ;  and  thus  is  explained  the  fact  that  the  unfor- 
tunate individual,  without  consciousness  of  the  meaning  of  his 
act,  or,  at  least,  without  cynicism,  does  it  in  obedience  to  a 
blind  impulse.  On  regaining  consciousness,  he  regrets  and 
abhors  it  if  there  is  not  permanent  mental  weakness. 

The  prime  motive  in  this  state  of  imperfect  consciousness, 
as  with  other  impulsive  acts,  is  a  feeling  of  apprehensive  oppres- 
sion. If  a  sexual  feeling  become  associated  with  it,  then  the 
ideas  are  given  a  certain  direction  in  the  sense  of  a  correspond- 
ing (sexual)  act. 

How  sexual  ideas  very  easily  arise  temporarily  in  epileptics 
may  be  understood  from  the  discussion  under  "  Epilepsy." 

If,  however,  such  an  association  has  once  been  formed ;  if 
a  particular  act  has  taken  place  in  an  attack, — it  is  the  more 
easily  repeated  in  every  subsequent  attack ;  for,  so  to  speak,  a 
known  tract  has  been  established  in  the  path  of  motivity. 

The  feeling  of  anxiety,  with  the  state  of  imperfect  con- 
sciousness, causes  the  associated  sexual  impulse  to  appear  as  a 
command, — an  inner  force,  which  is  acted  upon  in  a  purely 
impulsive  manner  and  in  a  state  of  absolute  irresponsibility. 

Case  170.  K.,  a  subordinate  official,  aged  29;  of  neuropathic  family; 
living  in  happy  marriage,  and  the  father  of  one  child.  He  has  repeatedly, 
especially  at  dusk,  exhibited  himself  to  servant-girls.  K.  is  tall,  slim, 
pale,  nervous,  and  hasty  in  manner.  There  is  imperfect  memory  of  the 
crimes.  Since  childhood  there  have  been  frequent  severe  congestive 
attacks,  with  intense  flushing  of  the  face,  a  rapid,  tense  pulse,  and  a 
fixed,  absent  stare.  At  the  same  time  there  were,  now  and  then,  confusion 
and  vertigo.  In  this  (epileptic)  exceptional  state  K.  would  answer  only 
after  repeated  questioning,  and  then  it  ivas  as  if  he  were  waking  from  a 
dream.  K.  states  that  he  has  always  felt  excited  and  restless  for  some 
hours  before  his  criminal  acts,  and  experienced  a  feeling  of  fear,  with 

25 


386  PSYCHOPATHIA   SEXUALIS. 

oppression,  and  congestion  of  the  head.  In  this  condition  he  had  often 
been  giddy,  and  experienced  an  indistinct  feeling  of  sexual  excitement. 
At  the  height  of  such  states  he  had  left  the  house,  without  any  purpose 
in  view,  and  exposed  his  genitals  anywhere.  When  he  had  reached  home 
again,  he  had  had  but  a  dreamy  remembrance  of  what  had  occurred,  and 
felt  very  weak  and  depressed.  It  is  also  remarkable  that,  while  exhib- 
iting his  genitals,  he  had  used  lighted  matches  to  make  them  visible. 
The  opinion  was  to  the  effect  that  the  criminal  acts  depended  upon 
epilepsy,  and  were  imperative  impulses ;  but  he  was,  nevertheless,  sen- 
tenced, with  the  assumption  of  extenuating  circumstances.  (Dr.  Schu- 
chardt,  op.  cit.). 

Case  171.  L.,  aged  39;  single;  tailor.  His  father  was  probably  a 
drinker  ;  he  had  two  epileptic  brothers,  one  of  whom  was  insane.  The 
patient  himself  has  slight  epileptic  attacks,  and  from  time  to  time  states 
of  imperfect  consciousness,  in  which  he  runs  about  aimlessty,  and  there- 
after does  not  know  where  he  has  been.  He  was  considered  a  moral 
man,  but  he  is  now  accused  of  having  exhibited  aud  pla3'ed  with  his 
genitals  in  a  strange  house  five  or  six  times.  His  memory  of  these  acts 
was  very  imperfect. 

On  account  of  repeated  desertion  from  the  army  (probably  likewise 
in  epileptic  states  of  imperfect  consciousness),  L.  had  been  severely 
punished.  In  imprisonment  he  became  insane  with  "  epileptic  insanity," 
was  sent  to  the  Charite,  and  from  there  discharged  "  cured."  As  far  as 
the  criminal  acts  were  concerned,  cynicism  and  wantonness  could  be  ex- 
cluded. That  they  were  committed  in  a  state  of  imperfect  consciousness 
is  probable  from  the  fact,  among  other  things,  that  to  the  policeman  who 
arrested  him,  the  "  imbecile,"  who  was  then  in  a  cloudy  state  of  con- 
sciousness, was  in  a  remarkable  mental  state.  (Liman,  Vierteljahrsschrift 
f.  ger.  Med.,  N.  F.  xxxviii,  H.  2.) 

Case  172.  L.,  aged  37.  From  October  15th  to  November  2d,  he 
had  man}'  times  given  offense,  by  exhibiting  himself  to  girls  in  daylight 
on  the  open  street,  and  even  in  schools,  into  which  he  forced  himself. 
It  happened  occasionally  that  he  wanted  the  girls  to  perform  manustu- 
pration  or  allow  coitus,  and,  when  refused,  he  performed  masturbation 
before  them.  In  G.,  in  a  public-house,  he  rapped  on  the  window,  with  his 
penis  exposed,  so  that  the  children  and  servant-girl  in  the  kitchen  were 
forced  to  see  it. 

After  his  arrest  it  was  ascertained  that  since  1876  L.  had  very  fre- 
quently caused  trouble  by  exhibitions,  but  had  always  escaped  punish- 
ment, owing  to  the  demonstration  of  mental  disease  by  physicians.  On 
the  other  hand,  he  had  been  punished  for  desertion  and  theft  in  the  army, 
and,  later,  once,  as  a  civilian,  for  stealing  cigars.  L.  had  repeatedly  been 
in  asylums  on  account  of  insanity  (attacks  of  insanity).  Besides,  he 
was  often  remarkable  on  account  of  his  changeable,  quarrelsome  character, 
occasional  excitement,  and  inconstancy. 


EXHIBITION.  387 

L.'s  brother  died  of  paralysis.  He  himself  presents  no  degenerative 
signs ;  no  epileptic  antecedents.  During  the  time  of  observation  he  is 
neither  insane  nor  mentally  weakened.  He  behaves  himself  very  well, 
and  expresses  great  regret  for  his  sexual  crimes.  About  himself  he 
states  that,  though  no  drinker,  he  occasionally  has  an  impulse  to  drink. 
Soon  after  beginning,  congestion  of  the  head,  vertigo,  restlessness,  anxiety, 
and  oppression  come  on.  He  then  passes  into  a  dreamy  state.  An  irre- 
sistible impulse  now  forces  him  to  expose  himself;  and  he  then  experi- 
ences a  feeling  of  relief  and  breathes  more  easily.  When  he  has  once 
exposed  himself,  he  knows  nothing  more  of  what  he  does.  As  precursors 
of  such  attacks,  he  had  often,  a  short  time  before,  had  flames  before  the 
eyes,  and  vertigo.  For  the  time  of  his  clouded  state  of  consciousness, 
he  had  but  a  clouded,  dreamy  memor}r. 

It  was  only  after  a  time  that  sexual  ideas  and  impulses  had  become 
associated  with  these  apprehensive,  cloudy  states  of  consciousness.  Years 
ago,  in  such  states,  without  motive  and  with  great  danger,  he  had 
deserted ;  once  he  had  jumped  from  a  third-story  window ;  on  another 
occasion  he  had  left  a  good  position  to  wander  about  aimlessly  in  a 
neighboring  country,  where  he  was  at  once  arrested  for  exhibition. 

When,  outside  of  his  abnormal  periods,  L.  once  became  intoxi- 
cated, there  was  no  exhibition.  In  the  lucid  state  his  sexual  feeling  and 
intercourse  are  perfectly  normal.  (Dr.  Hotzen,  Friedreich's  Blatter, 
1890,  H.  6).     For  other  instances,  vide  Cases  153,  155. 

A  clinical  group  that  very  nearly  approaches  the  epileptic 
exhibitionists  is  made  up  of  certain  neurasthenic  individuals,  in 
whom,  likewise,  there  may  occur  attacks  (epileptoid  V)  of  imper- 
fect consciousness1  in  connection  with  a  feeling  of  apprehensive 
oppression ;  and  with  this  sexual  impulses  may  be  associated, 
resulting  in  acts  of  exhibition  having  an  impulsive  character. 

Case  173.  Dr.  S.,  academic  teacher,  had  aroused  public  indignation 
by  being  seen  repeatedly  running  about  in  the  Zoological  Garden  at 
Berlin,  before  ladies  and  children,  with  his  genitals  hanging  out.  S. 
admitted  this,  but  denied  all  thought  or  consciousness  of  causing  public 
offense,  and  excused  himself  by  saying  that  his  running  about  with 
exposed  genitals  afforded  him  relief  from  nervous  excitement.  Mother's 
father  was  insane,  and  died  by  suicide;  his  mother  was  constitutionally 
neuropathic,  a  somnambulist,  and  had  been  temporarily  insane.  The 
culprit  was  neuropathic,  had  been  a  somnambulist,  and  had  had  contin- 
uous aversion  to  sexual  intercourse  with  females.     In  his  youth  he  prac- 

1  Comp.  v."  Krafft,  "  Ueber  transitorisches  Irresein  bei  Neurasthenischen,"  Irren- 
freund,  1883,  No.  8. 


388  PSYCHOPATHIA   SEXUALIS. 

ticed  onanism.  He  was  a  neurasthenic  man,  shy,  torpid,  and  easily 
became  embarrassed  and  confused.  He  was  sexually  always  much 
excited.  Frequently  he  dreamed  that  he  was  running  about  with 
exposed  genitals,  or  that,  dressed  only  in  a  shirt,  he  hung  from  a  fence 
with  his  head  downward,  so  that  the  shirt  fell  down,  exposing  his  erected 
penis.  His  dreams  would  induce  pollution,  and  he  would  then  have  rest 
for  a  few  days  or  an  entire  week. 

Also,  in  his  waking  state,  the  impulse  would  often  come  upon  him, 
just  as  in  his  dreams,  to  run  about  with  exposed  genitals.  As  he  was 
about  to  expose  himself,  he  would  become  very  hot,  and  then  he  would 
run  aimlessly  about.  The  member  would  become  moist  with  secretion, 
but  pollution  was  never  induced.  Finally,  when  it  had  become  flaccid, 
he  would  put  it  up,  and  then  come  to  himself,  glad  if  no  one  had  seen 
him.  In  such  conditions  of  excitement  he  seemed  to  be  in  a  dream ;  as 
if  intoxicated.  He  had  never  had  the  intention  to  offend  women.  S. 
was  not  epileptic.  His  declarations  had  the  impress  of  truth.  He  had 
actually  never  followed  or  spoken  to  women  while  in  this  condition. 
Frivolity  and  coarseness  were  excluded.  In  agreement  with  Westphal, 
the  author  regards  S.  as  belonging  "  to  a  class  of  individuals  of  peculiar 
hypochondriacal  tendencies,  in  whom  the  attention  is  constantly  directed, 
in  an  abnormal  way,  to  certain  bodity  sensations  and  processes  ;  who 
brood  over  these,  connecting  all  kinds  of  peculiar  conceptions  with  them, 
at  last  making  use  of  quite  as  strange  means  to  combat  the  bodily 
sensations  and  ideas."  At  least,  S.'s  act  was  due  to  pathological  sensa- 
tion and  idea,  and  S.  was  in  a  condition  of  pathological  disturbance  of 
mental  action  at  the  time  of  the  commission  of  his  acts.  In  the  case  of 
this  exhibitionist,  the  manner  of  satisfaction  of  the  sexual  instinct  may 
be  considered  as  peculiar  to  the  individual.  (Liman,  Vierteljahrsschrift 
fur  gerichtel.  Med.,  N.  F.  xxxviii,  Heft  2.) 

Case  174.  X.,  aged  38;  married;  father  of  one  child.  Always 
sullen  and  silent.  Suffers  frequently  with  headache.  Very  neurasthenic, 
though  not  insane.  He  is  troubled  much  at  night  by  pollutions.  He 
has  repeatedly  followed  shop-girls,  for  whom  he  had  lain  in  wait,  expos- 
ing and  handling  his  genitals.  In  one  case  he  even  followed  a  girl  into 
a  shop.     (Trochon,  Arch,  de  V anthropologic  criminelle,  iii,  p.  256.) 

In  the  following  case  the  exhibition  seems  subsidiary  to 
the  impulsive  desire  to  satisfy  sudden,  intense  libido,  by  means 
of  masturbation : — 

Case  175.  R.,  coachman,  aged  49,  Vienna;  married  since  1866; 
childless.  Father  neuropathic  and  given  to  sexual  excesses ;  died  of 
cerebral  disease.     He  preseuts  no  degenerative  signs. 

At  the  age  of  twenty-nine  he  suffered  a  severe  concussion  by  fall- 
ing from  a  height.     Up  to  that  time  the  vita  sexualis  had  been  normal. 


EXHIBITION.  389 

Since  that  time,  every  three  or  four  months,  he  has  been  seized  with  very 
painful  sexual  excitement,  accompanied  by  an  intense  desire  to  mastur- 
bate. A  feeling  of  weariness  and  discomfort,  with  a  desire  for  alcoholic 
indulgence,  precedes  this.  In  the  intervals  he  is  sexually  cold,  and  has 
but  very  infrequent  desire  for  his  wife,  who,  moreover,  for  five  years  has 
been  sick,  and  incapable  of  cohabitation.  He  gives  the  assurance  that,  as 
a  young  man,  he  never  masturbated,  and  that,  in  the  intervals  between  his 
attacks,  he  has  never  thought  of  satisfying  himself  sexually  in  this  way. 

The  impulse  to  masturbation  during  the  attack  is  always  excited 
by  certain  feminine  charms, — short  cloak,  pretty  foot  and  ankle,  elegant 
appearance.  Age  makes  no  difference ;  even  little  girls  excite  him.  The 
impulse  is  sudden  and  unconquerable.  R.  describes  the  situation  and 
act  as  characteristically  impulsive.  He  had  often  tried  to  resist  it; 
but  then  he  would  grow  hot,  terribly  frightened,  his  head  would  burn, 
and  he  would  seem  to  be  in  a  fog ;  but  he  never  lost  consciousness.  At 
the  same  time  he  would  have  violent,  darting  pain  in  the  testicles  and 
spermatic  cords.  He  regretted  it,  but  had  to  confess  that  the  impulse 
was  stronger  than  his  will.  In  such  a  situation  it  forced  him  to  mastur- 
bate, no  matter  where  he  might  be.  After  ejaculation  he  would  become 
calm,  and  regain  his  self-control.  He  regarded  it  as  a  terrible  affliction. 
Defense  shows  that  R.  has  been  punished  six  times  for  similar  offenses 
— exhibition  and  masturbation  in  the  open  street. 

On  November  4,  1889,  R.,  while  in  his  worst  condition,  happened 
to  be  in  the  street  as  a  crowd  of  school-girls  went  by.  This  awakened 
his  unconquerable  impulse.  There  was  not  time  to  run  to  a  closet,  he 
was  so  excited.  There  was  immediate  exhibition,  masturbation  in  front 
of  a  house, — great  scandal  and  immediate  arrest.  R.  is  not  weak- 
minded,  and  has  no  ethical  defect.  He  bemoans  his  fate,  deeply  regrets 
his  act,  and  fears  new  attacks.  He  regards  his  condition  as  abnormal, 
— as  a  fate  against  which  he  is  powerless. 

He  thinks  himself  still  virile.  Penis  abnormally  large.  Cremas- 
teric reflex  present;  patellar  reflex  increased.  Weakness  of  the  sphincter 
of  the  bladder,  that  has  existed  for  some  years.  Various  neurasthenic 
difficulties. 

The  opinion  showed  that  R.  was  subject  to  the  influence  of  abnor- 
mal conditions,  and  had  acted  impulsive^.  Patient  was  sent  to  an 
asylum,  from  which  he  was  discharged  after  a  few  months. 

In  the  foregoing  case  the  important  point,  clinically,  lies 
not  in  the  neurosis  that  is  present,  but  rather  in  the  impulsive 
character  of  the  act  (exhibition  dependent  on  masturbation). 

With  the  enumeration  of  the  categories  of  imbeciles,  of 
mentally  weakened  individuals,  and  of  the  exhibitionists  that 


390  t»SYCHOPATHlA   SEXUALlS. 

are  in  a  neurotic  (epileptic  or  neurasthenic)  state  of  imperfect 
consciousness,  apparently  the  clinical  and  forensic  side  of  this 
phenomenon  is  still  unexhausted ;  in  addition  to  these,  there  is 
another  class,  the  representatives  of  which,  owing  to  deep  hered- 
itary taint  (hereditary  degenerative  neurosis  ?),  are  impelled  to 
periodical  and  very  impulsive  exhibition. 

With  reference  to  these  conditions  of  psychopathia  sexualis 
periodica  (comp.  "  Periodical  Insanity"),  in  which  the  acci- 
dentally-awakened impulse  to  exhibition  is  but  a  partial  mani- 
festation of  a  clinical  whole,  like  dipsomania  periodica,  Magnan, 
from  whom  I  borrow  the  following  instructive  cases,  justly  lays 
the  greatest  stress  upon  the  impulsive,  periodical  feature  of 
these  abnormal  impulses ;  and  no  less  upon  the  fact  that  they 
are  often  accompanied  by  terrible  anxiety,  which,  after  the  reali- 
zation of  the  impulse,  gives  place  to  a  feeling  of  relief. 

These  facts,  and,  no  less,  the  clinical  picture  of  degeneracy 
that,  for  the  most  part,  is  referable  to  injurious  conditions  that 
are  hereditary,  or  that  exercise  an  injurious  effect  on  the  devel- 
opment of  brain  in  early  years  (rachitis,  etc.),  are,  medico- 
legally,  of  decisive  importance  [with  reference  to  the  question 
of  responsibility]. 

Case  176.  G.,  aged  29,  waiter  in  a  cafe.  In  1888,  while  standing 
under  a  church-door,  he  exhibited  himself  to  several  girls  working  oppo- 
site. He  confessed  the  act,  and  also  that,  many  times,  in  the  same  place 
and  at  the  same  time  of  day,  he  had  been  guilty  of  the  same  crime,  having 
been  punished  for  it,  the  year  before,  with  imprisonment  for  one  month. 

G.  has  very  nervous  parents.  His  father  is  mentally  unstable  and 
very  irascible.  His  mother  is  at  times  insane,  and  suffers  with  severe 
nervous  disease. 

G.  has  always  had  nervous  twitching  of  the  face,  and  constant  alter- 
nation of  causeless  depression,  with  tsedium  vitae,  and  periods  of  elation. 
At  the  ages  of  ten  and  fifteen,  for  slight  cause,  he  wished  to  commit 
suicide.  When  excited,  he  has  similar  twitching  of  the  extremities.  He 
presents  constant  general  analgesia.  In  prison  he  was  at  first  beside 
himself  with  shame  about  the  disgrace  he  had  brought  on  his  family,  and 
said  he  was  the  worst  of  men,  deserving  the  severest  punishment. 

Until  his  nineteenth  year  G.  had  satisfied  himself  with  solitary 
and  mutual  masturbation,  and,  on  one  occasion,  he  had  practiced  onan- 
ism with  a  girl.  From  that  time,  working  in  a  cafe,  the  female  cus- 
tomers had  excited  him  so  intensely  that  ejaculation  was  often  induced. 


EXHIBITION.  391 

He  suffered  with  almost  constant  priapism,  and,  as  bis  wife  stated,  in 
spite  of  coitus,  it  often  disturbed  bis  rest  at  night.  For  seven  years  be 
bad  repeatedly  exhibited  himself  at  his  window,  and  also  exposed 
himself  naked  to  female  neighbors  living  opposite. 

In  1883  he  married  out  of  desire.  Marital  intercourse  did  not 
satisfy  his  needs.  At  times  his  sexual  excitement  was  so  intense  that 
he  had  headache,  and  seemed  confused,  like  one  drunk,  strange,  and 
incapable  of  work. 

Case  177.  B.,  aged  27  ;  of  neuropathic  mother  and  alcoholic  father. 
He  has  one  brother  who  is  a  drinker;  and  an  hysterical  sister. 

After  his  eleventh  year,  onanism,  solitary  or  mutual.  After  his 
fifteenth  year,  impulses  to  exhibition.  He  attempted  it  at  a  street- 
urinal  ;  he  felt  pleasure  in  it,  but  also  immediately  twinges  of  con- 
science. If  be  attempted  to  oppose  his  impulse  thereafter,  he  became 
apprehensive,  and  had  a  feeling  of  oppression  in  bis  chest.  When  a 
soldier,  he  was  often  impelled  to  expose  himself,  under  various 
pretexts,  to  his  comrades. 

After  his  seventeenth  year  he  had  sexual  congress  with  women. 
It  gave  him  great  pleasure  to  show  himself  naked  before  them.  He  con- 
tinued his  exhibition  on  the  sti'eet.  Since  he  could  but  infrequently 
count  on  female  spectators  at  urinals,  he  changed  his  place  to  churches. 
In  order  to  exhibit  himself  at  such  places,  he  always  had  to  strengthen 
his  courage  by  drinking.  Under  the  influence  of  spirits,  the  impulse,  at 
other  times  controllable  with  difficulty,  became  irresistible.  He  was  not 
sentenced.  He  lost  his  position,  and  then  drank  more.  Not  long  after, 
he  was  again  arrested  for  exhibition  and  masturbation  in  a  church. 

Case  178.  X.,  aged  35;  barber's  assistant.  Repeatedly  punished 
for  offense  against  decency,  he  is  again  arrested;  for,  during  three 
weeks,  he  had  been  hanging  around  girls'  schools,  trying  to  attract  the 
attention  of  the  pupils,  and,  when  he  had  succeeded  in  this,  had  exhib- 
ited himself.  Occasionally  he  bad  promised  them  money,  with  the 
words,  "  Habeo  mentulam  pulcberrimam,  venite  ad  me  ut  earn  lambatis." 
At  his  examination  X.  confessed  everything,  but  did  not  know  how  it 
had  come  about.  He  was  the  most  reasonable  of  men  in  other  respects, 
but  had  the  impulse  to  commit  this  crime,  and  could  not  overcome  it. 

In  1879,  when  in  the  army,  he  was  once  out  on  leave,  and  had  run 
around  exhibiting  himself  to  children  :  imprisonment  for  a  year.  The 
same  crime  in  1881.  He  chased  the  crying  children,  and  "  stared  "  at 
them  :  imprisonment  of  one  year  and  three  months.  Two  days  after  his 
discharge,  he  said  to  two  little  girls  :  "  If  you  want  to  see  my  tail,  come 
with  me  to  this  (market)  booth."  He  denied  these  words,  and  claimed 
drunkenness  :  imprisonment  for  three  months. 

In  1883,  renewed  exhibition  ;  during  the  act  he  said  nothing.  At  his 
examination  he  stated  that,  since  a  severe  illness,  eight  years  previously, 
he  had  suffered  with  such  excitations :  imprisonment  for  one  month. 


392  PSYCHOPATHIA   SEXUALIS. 

In  1884,  exhibition  before  girls  in  a  church-yard;  again  in  1885. 
He  declared  :  "  I  understand  my  crime,  but  it  is  like  a  disease.  When 
it  comes  over  me,  I  cannot  keep  from  such  acts.  It  sometimes  happens 
that,  for  quite  a  long  time,  I  am  free  from  these  inclinations."  Imprison- 
ment for  six  months. 

Discharged  on  August  12,  1885,  he  had  a  relapse  on  August  15. 
The  same  excuse  was  given.  This  time  he  underwent  medical  examina- 
tion. The  examination  revealed  no  mental  disturbance.  Sentenced  to 
three  years.  After  discharge,  a  series  of  new  exhibitions.  On  this 
occasion,  examination  revealed  the  following : — 

His  father  suffered  with  chronic  alcoholism,  and  is  said  to  have 
been  guilty  of  the  same  crime.  Mother  and  sister  nervously  ill,  and  the 
whole  family  of  excitable  temperament. 

From  his  seventh  to  his  eighteenth  year  X.  suffered  with  epileptic 
convulsions.  First  cohabitation  at  sixteen  ;  later,  gonorrhoea  and,  it  is 
stated,  syphilis.  After  that,  normal  sexual  intercourse  until  his  twenty- 
first  year.  At  that  time  he  often  had  to  pass  a  play-ground,  and  he 
occasionally  had  to  urinate  there;  and  it  happened  that  the  children 
looked  at  him,  out  of  curiosity. 

He  noticed,  occasional^,  that  this  looking  at  him  caused  him  sexual 
excitement,  and  induced  erection,  and  even  ejaculation.  He  now  found 
more  pleasure  in  this  kind  of  sexual  gratification,  and  became  indifferent 
about  coitus,  satisfying  himself  only  in  this  manner.  He  felt  that  all  his 
thought  was  ruled  by  this,  and  he  dreamed  only  of  exhibitions,  with 
pollutions.  His  attempts  to  control  his  impulse  became  more  and  more 
ineffectual.  It  came  over  him  with  such  force  that  he  noticed  nothing 
around  him,  and  saw  and  heard  nothing,  and  was  like  one  "  devoid  of 
reason," — like  "  a  bull  trying  to  butt  his  head  through  a  wall." 

X.  has  an  abnormally  broad  head.  Small  penis ;  the  left  testicle 
deformed.  Patellar  reflex  absent.  Sjrmptoms  of  neurasthenia,  espe- 
cially cerebral.  Frequent  pollutions.  For  the  most  part,  his  dreams 
are  about  normal  coitus,  only  infrequently  about  exhibition  before  little 
girls. 

With  reference  to  his  sexual  acts,  he  states  that  the  impulse  to 
seek  and  approach  little  girls  is  primary  ;  only  when  he  has  succeeded  in 
attracting  their  attention  to  his  exposed  genitals  do  erection  and  ejacu- 
lation occur.  He  does  not  lose  consciousness  in  the  act.  After  it  he  is 
troubled  about  his  deed,  and,  if  undiscovered,  sa3Ts  to  himself,  "  Once 
more  I  have  escaped  the  authorities." 

In  prison  he  did  not  have  the  impulse ;  there,  he  was  troubled  only 
with  dreams  and  pollutions.  In  freedom  he  had  daily  sought  oppor- 
tunity to  satisf}'  himself  with  exhibition.  He  would  give  ten  years  of 
his  life  to  be  free  from  the  thing;  "this  life  of  constant  anxiety,  this 
alternation  between  freedom  and  imprisonment,  is  unendurable." 

The  opinion  assumed   a  congenital   (?)  perversity  of  the  sexual 


EXHIBITION.        .  393 

instinct,  with  unmistakable  hereditary  taint,  neuropathic  constitution, 
as}rmmetry  of  cranium,  and  defective  development  of  the  genitals. 

It  is  also  worthy  of  remark  that  the  exhibition  began  when  the 
epilepsy  ceased;  so  that  one  might  think  of  a  vicarious  phenomenon. 

The  sexual  perversity  developed,  with  predisposition,  through 
accidental  association  of  ideas  of  sexual  content  (children  looking  at 
him  while  urinating)  with  an  act  that,  in  itself,  was  purposeless. 

The  patient  was  not  sentenced,  but  sent  to  an  asylum.  (Dr. 
Freyer,  Zeitschr.f.  Medicinalbeamte ,  3  Jahrg.,  No.  8.) 

Case  179.  At  9  o'clock  at  night,  in  the  spring  of  1891,  a  lady,  in 
great  trepidation,  came  to  the  policeman  in  the  city  park  of  X.,  with  the 
statement  that  a  man,  absolutely  naked  in  front,  had  approached  her 
from  the  bushes,  and  she  had  run  away,  frightened.  The  officer  went  at 
once  to  the  place  indicated,  and  found  a  man,  who  exposed  ventrem  et 
genitalia  nuda.  He  attempted  to  escape,  but  was  overtaken  and  arrested. 
He  stated  that  he  had  been  sexually  excited  by  alcohol,  and  had  been  on 
the  point  of  going  to  a  prostitute.  On  his  way  through  the  park,  how- 
ever, he  recalled  the  fact  that  exhibition  gave  him  much  greater  pleasure 
than  was  afforded  him  by  coitus,  in  which  he  seldom,  and  only  faute  de 
mieux,  indulged.  After  drawing  up  his  shirt,  he  posted  himself  in  the 
bushes,  and,  when  two  women  came  up  the  path,  he  approached  them 
with  exposed  genitals.  In  such  exhibition  he  had  a  pleasurable  feeling 
of  warmth,  and  the  blood  mounted  to  his  head. 

The  accused  works  in  a  manufactory,  and  his  employer  states  that 
he  is  faithful,  saving,  sober,  and  intelligent. 

In  1886  B.  had  been  punished  because  he  had  twice  exhibited 
himself  publicly, — once  in  broad  daylight,  and  once  at  night,  under  a 
lamp. 

B.,  aged  37,  single,  makes  a  peculiar  impression,  owing  to  his  dandi- 
fied dress  and  affected  manner.  His  eyes  have  a  neuropathic,  languishing 
expression  ;  around  his  mouth  plays  a  smile  of  self-satisfaction.  He  is 
said  to  come  of  healthy  parents.  A  sister  of  his  father,  and  one  of  his 
mother,  were  insane.  Others  of  their  relatives  were  thought  religiously 
eccentric. 

B.  has  never  had  any  severe  illness.  From  childhood  he  was 
eccentric  and  imaginative.  He  loved  romances  about  knights  and 
others,  was  entirely  absorbed  by  them,  and  even  went  so  far  as  to 
identify  himself  in  fancy  with  the  heroes.  He  always  thought  himself  a 
little  better  than  others,  and  thought  much  of  elegant  dress  and  orna- 
ment; and  when  he  strutted  about  on  Sunda3rs,  he  imagined  himself  a 
high  official. 

B.  has  never  had  epileptic  symptoms.  In  youth,  moderate  in- 
dulgence in  masturbation ;  later,  moderate  indulgence  in  coitus.  Pre- 
viously, never  an}T  perverse  sexual  feelings  or  impulses.  Retired  manner 
of  life ;  in  leisure  hours,  reading  (popular  novels,  heroic  tales,  Dumas, 


394  i  PSYCHOPATH!  A   SEXUALIS. 

and  others).  B.  was  no  drinker.  Exceptionally  he  made  himself  a  kind 
of  punch,  hy  which  he  was  always  excited  sexually. 

For  some  years,  with  marked  decrease  of  libido,  after  such  alco- 
holic indulgence,  he  had  had  "  accursedly  silly  thoughts,"  and  developed 
the  desire  genitalia  adspectui  feminarum  publice  exhibere. 

If  he  got  into  this  state,  he  felt  warm,  his  heart  beat  violently, 
blood  rushed  to  his  head,  and  he  could  then  no  longer  resist  his  impulse. 
He  heard  and  saw  nothing  more,  and  was  absolutely  absorbed  in  his 
lust.  Afterward  he  had  often  pounded  his  crazy  head  with  his  fists,  and 
firmly  resolved  never  to  do  such  a  thing  again  ;  but  the  crazy  ideas  had 
alwaj^s  returned. 

In  his  exhibition  his  penis  became  only  half-erected,  and  ejaculation 
never  occurred  ;  even  in  coitus  it  was  always  tardy.  In  exhibition  he 
was  satisfied  with  genitalia  sua  adspicere,  and  he  had  the  lustful  thought 
that  this  sight  must  be  very  pleasant  to  women,  since  he  liked  so  much 
to  see  genitalia  feminarum.  He  was  capable  of  coitus  only  when  the 
puella  showed  herself  very  partial  to  him ;  without  this,  he  preferred 
rather  to  pay  and  go  without  doing  anything.  In  his  dreams  he  exhib- 
ited himself  to  young,  voluptuous  women. 

The  medico-legal  opinion  recognized  the  hereditary  ps3rchopathic 
character  of  the  culprit,  and  the  perverse,  impulsive  desire  to  perform 
the  incriminating  acts ;  and  pointed  out,  further,  the  remarkable  fact 
that  in  B.,  who  was  otherwise  sober  and  saving,  the  impulses  to  indulge 
in  alcohol  depended  on  abnormal  conditions  that  recurred  periodicallj-, 
and  forced  him  to  indulge.  That,  during  his  attacks,  B.  was  in  an 
exceptional  psychical  state,  in  a  kind  of  mental  confusion,  and  abso- 
lutely absorbed  in  his  perverse  sexual  fancy,  is  clearly  shown  by  the 
species  facti.  Thus  is  explained  the  fact  that  he  became  aware  of  the 
approach  of  the  police  only  when  it  was  too  late  to  try  to  escape.  In 
this  hereditary  and  degenerate  impulsive  exhibitionism,  it  is  interesting 
to  note  how  the  perverse  sexual  impulse  is  awakened  from  its  latency  by 
the  influence  of  alcohol. 

A  forensically  important  variety  of  exhibition,  which,  clini- 
cally, certainly  rests  upon  a  similar  neurotic  and  degenerate 
foundation,  and  which  expresses  itself  in  a  peculiar  act,  con- 
ditioned by  violent  libido  (hyperesthesia  sexualis),  associated 
with  diminished  virility,  is  made  up  of  the  so-called  frotteurs. 

The  three  following  cases,  borrowed  from  Magnan  (op.  tit), 
are  typical : — 

Case  180.  D.,aged  44,  hereditarily  predisposed,  drinker,  and  suffer- 
ing with  lead  poisoning.  Until  the  last  year  he  had  masturbated  much, 
and  often  drawn  pornographic  pictures,  and  shown  them  to  his  acquaint- 


FROTTAGE.  395 

ances.  He  had  repeatedly  dressed  himself  as  a  woman  in  secret.  For 
two  years,  since  becoming  impotent,  he  had  felt  desire,  while  in  crowds 
at  dusk,  mentulam  denudare  eamque  ad  nates  mulieris  crassissimre 
terere.  Once,  when  discovered  in  the  act,  he  had  been  sentenced  to 
imprisonment  for  four  months. 

His  wife  kept  a  milk-shop.  Iterum  iterumqne  sibi  temperare  non 
potuit  quin  genitalia  in  ollam  lacte  completam  mergeret.  In  the  act  he 
felt  lustful  pleasure,  "  as  if  touched  with  velvet."  He  was  cynical 
enough  to  use  this  milk  for  himself  and  the  customers.  During  impris- 
onment alcoholic  persecutory  insanity  developed  in  him. 

Case  181.  M.,  aged  31 ;  married  six  years;  father  of  four  children; 
badly  predisposed;  subject  to  melancholia  at  times.  Three  years  before, 
he  was  discovered  by  his  wife  with  a  silk  dress  on,  masturbating.  One 
day  he  was  discovered,  in  a  store,  in  the  act  of  frotiage  on  a  lady.  He 
was  very  repentant,  and  asked  to  be  severely  punished  for  his  irresistible 
impulse. 

Case  182.  G.,  aged  33;  badly  predisposed  hereditarily.  At  an 
omnibus-station  he  was  discovered  in  the  act  of  f voltage  with  his  penis 
on  a  lad}'.  Deep  repentance  ;  but  he  stated  that  at  the  sight  of  a  notice- 
able posteriora  of  a  lady,  he  was  irresistibly  impelled  to  practice  frot- 
tage,  and  that  he  became  confused  and  knew  not  what  he  did.  Sent  to 
an  asylum. 

Case  183.  A  frotteur.  Z.,  born  in  1850;  of  blameless  life  previ- 
ously ;  of  good  family  ;  private  official.  He  is  well-to-do  financially  ; 
untainted.  After  a  short  married  life  he  became  a  widower,  in  1873. 
For  some  tin?1  he  had  attracted  attention  in  churches,  because  he 
crowded  up  behind  women,  both  old  and  young  indifferently,  and  toyed 
with  their  tournures.  He  was  watched,  and  one  day  he  was  arrested  in 
the  act.  Z.  was  terribly  frightened,  and  in  despair  about  his  situation  ; 
and,  in  making  a  full  confession,  he  begged  for  pardon,  for  nothing  but 
suicide  remained  for  him. 

For  two  years  he  had  been  subject  to  the  unhappy  impulse  to  go  in 
crowds  of  people, — in  churches,  at  box-offiees  of  theatres,  etc, — and 
press  up  behind  females  and  manipulate  the  prominent  portion  of  their 
dresses,  having  orgasm  and  ejaculation  during  the  act. 

Z.  states  that  he  was  never  given  to  masturbation,  and  had  never 
been  in  any  way  perverse  sexually.  Since  the  early  death  of  his  wife, 
he  had  gratified  his  great  sexual  desire  in  temporary  love-affairs,  having 
always  had  an  aversion  for  prostitutes  and  brothels.  The  impulse  to 
frotiage  had  suddenly  seized  him,  two  years  before,  while  he  happened  to 
be  in  church.  Though  he  was  conscious  that  it  was  wrong,  he  could  not 
help  yielding  to  it  immediatel}'.  Since  then  he  had  been  excitable  to  the 
posteriora  of  females,  and  had  been  actually  impelled  to  seek  opportu- 
nity for  frotiage.  The  only  thing  on  women  that  excited  him  was  the 
tournure  ;  every  other  part  of  the  body  and  attire  was  a  matter  of  indiffer- 


396  PSYCHOPATHIA   SEXUALIS. 

ence  to  him ;  and  it  made  no  difference  to  him  whether  the  woman  was' 
old  or  young,  beautiful  or  ugl}'.  Since  this  began,  he  had  had  no  more 
inclination  for  natural  gratification.  Of  late  frottage  scenes  had  appeared 
in  his  dreams.  During  his  acts  he  was  fully  conscious  of  his  situation 
and  the  act,  and  tried  to  perform  it  in  such  a  way  as  to  attract  as  little 
attention  as  possible.  After  his  act  he  was  always  ashamed  of  what  he 
had  done. 

The  medical  examination  revealed  no  sign  of  mental  disease  or 
mental  weakness,  but  symptoms  of  neurasthenia  sexualis, — ex  abstinentia 
libidinosi  (?), — which  was  also  proved  by  the  circumstance  that  even 
simple  touching  of  the  fetich  with  the  unexposed  genitals  sufficed  to 
induce  ejaculation.  Apparently  Z.,  weakened  sexually  and  distrusting 
his  virility,  and  yet  libidinous,  had  come  to  practice  frottage  by  having 
the  sight  of  posteriora  feminse  fall  together  accidentally  with  sexual 
excitement ;  and  this  associative  combination  of  a  perception  with  a 
feeling  permitted  the  former  to  attain  the  significance  of  a  fetich. 

As  an  act  which  offends  public  morals,  and  which  is,  there- 
fore, punishable,  the  violation  of  statues — a  whole  series  of  cases 
of  which  Moreau  (pp.  cit.)  has  collected  from  ancient  and  modern 
times — may  be  enumerated  here.  They  are,  unfortunately,  given 
too  much  like  anecdotes  to  allow  satisfactory  judgment  of  them. 
They  always  give  the  impression  of  being  pathological, — like  the 
story  of  a  young  man  (related  by  Lucianus  and  St.  Clemens,  of 
Alexandria)  who  made  use  of  a  Venus  of  Praxiteles  for  the 
gratification  of  his  lust ;  and  the  case  of  Clisyphus,  who  violated 
the  statue  of  a  goddess  in  the  Temple  of  Samos,  after  having 
placed  a  piece  of  meat  on  a  certain  part.  In  modern  times,  the 
Journal  Uevenement  of  March  4,  1877,  relates  the  story  of  a 
gardener  who  fell  in  love  with  a  statue  of  the  Venus  of  Milo, 
and  was  discovered  attempting  coitus  with  it.  At  any  rate, 
these  cases  stand  in  etiological  relation  with  abnormally  intense 
libido  and  defective  virility  or  courage,  or  lack  of  opportunity  for 
normal  sexual  gratification. 

The  same  thing  must  be  assumed  in  the  case  of  the 
so-called  voyeurs? — i.e.,  men  who  are  so  cynical  that  they  seek  to 

1  Dr.  Moll  calls  this  perversion  (?)  mixoscopia  (from  /u£ts,  cohabitation ;  and 
ffKetrretv,  to  look).  His  assumption  that  it  is  related  to  masochism,  in  that  there  is  a 
stimulus  for  the  voyeur  in  suffering  at  seeing  a  woman  in  the  possession  of  another,  does 
not  seem  to  me  to  be  justified.  For  further  details,  vide  Moll,  "  Die  contrare  Sexual- 
empfindung,"  p.  137. 


LUST-MURDER.  397 

get  sight  of  coitus,  in  order  to  assist  their  virility ;  or  who  seek  to 
have  orgasm  and  ejaculation  at  the  sight  of  an  excited  woman. 
Concerning  this  moral  aberration,  which,  for  various  reasons, 
cannot  be  further  described  here,  it  will  suffice  to  refer  to  Coffig- 
non's  book,  "  La  Corruption  a  Paris."  The  revelations,  in  the 
domain  of  sexual  perversity,  and  also  perversion,  which  this  book 
makes,  are  horrible. 

2.  Rape  and  Lust-Murder. 

(Austrian  Statutes,  §  125, 121 ;  Austrian  Abridgment,  §  192  ;  German 

Statutes,  §  177.) 

By  the  term  rape,  the  jurist  understands  coitus,  outside  of 
the  marriage  relation,  with  an  adult,  enforced  by  means  of 
threats  or  violence ;  or  with  an  adult  in  a  condition  of  defense- 
lessness  or  unconsciousness;  or  with  a  girl  under  the  age  of 
fourteen  years.  Immissio  penis,  or,  at  least,  conjunctio  mera- 
brorum  (Schutze),  is  necessary  to  establish  the  fact.  To-day, 
rape  on  children  is  remarkably  frequent.  Hofmann  ("  Ger. 
Med.,"  i,  p.  155)  and  Tardieu  ("Attentats")  report  horrible  cases. 

The  latter  establishes  the  fact  that,  from  1851  to  1875 
inclusive,  22,017  cases  of  rape  came  before  the  courts  in  France, 
and,  of  these,  17,657  were  committed  on  children. 

The  crime  of  rape  presumes  a  temporary,  powerful  excita- 
tion of  sexual  desire,  induced  by  excess  in  alcohol,  or  by  some 
other  condition.  It  is  highly  improbable  that  a  man  morally 
intact  would  coruVnit  this  most  brutal  crime.  Lombroso  (Golt- 
dammer's  Arch.)  considers  the  majority  of  men  who  commit 
rape  to  be  degenerate,  particularly  when  the  crime  is  done  on 
children  or  old  women.  He  asserts  that,  in  many  such  men, 
he  has  found  actual  signs  of  degeneracy. 

It  is  a  fact  that  rape  is  very  often  the  act  of  degenerate 
male  imbeciles,1  where,  under  some  circumstances,  the  bond  of 
blood  is  not  respected. 

Cases  as  a  result  of  mania,  satyriasis,  and  epilepsy,  have 
occurred,  and  are  to  be  kept  in  mind. 

i  Annal.  medico-psychol.,  1849,  p.  515;  1S63,  p.  57;  1864,  p.  215;  1866,  p.  253. 


398  PSYCHOPATHIA   SEXUALIS. 

The  crime  of  rape  may  follow  the  murder  of  the  victim.1 
There  may  be  unintentional  murder,  murder  to  destroy  the  only 
witness  of  the  crime,  or  murder  out  of  lust  (v.  supra).  Only 
for  cases  of  the  latter  kind  should  the  term  lust-murder2,  be 
used. 

The  motives  of  lust-murder  have  been  previously  consid- 
ered. The  cases  given  in  illustration  are  characteristic  of  the 
manner  of  the  deed.  The  presumption  of  a  murder  out  of  lust 
is  always  given  when  injuries  of  the  genitals  are  found,  the 
character  and  extent  of  which  are  such  as  could  not  be  ex- 
plained by  merely  a  brutal  attempt  at  coitus ;  and,  still  more, 
when  the  body  has  been  opened,  or  parts  (intestines,  genitals) 
torn  out,  and  are  wanting. 3 

Lust-murders  dependent  upon  psychopathic  conditions  are 
never  committed  with  accomplices. 

Case  184.  Weak-mindedness,  Epilepsy.  Attempt  at  Rape ;  Murder. 
— On  the  evening  of  May  27,  1888,  an  eight-year-old  boy,  Blasius,  was 
playing  with  other  children  in  the  neighborhood  of  the  village  of  S. 
An  unknown  man  came  along  and  enticed  the  boy  into  the  woods.  The 
next  day  the  boy's  body  was  found  in  a  ravine,  with  the  abdomen  slit 
open,  an  incised  wound  in  the  cardiac  region,  and  two  stab-wounds  in  the 
neck. 

Since,  on  May  21st,  a  man,  answering  to  the  description  given 
of  the  murderer  by  the  children,  had  attempted  to  treat  a  six-year-old 
girl  in  a  similar  manner,  and  had  only  accidentally  been  detected,  it  was 
presumed  to  be  a  case  of  lust-murder.  It  was  proved  that  the  body 
was  found  in  a  heap,  with  only  the  shirt  and  jacket  on ;  also,  that  there 
was  a  long  incision  in  the  scrotum. 

Suspicion  fell  upon  a  peasant,  B. ;  but,  on  confrontation  with  the 
children,  it  was  not  possible  to  identify  him  with  the  stranger  who  had 
enticed  the  boy  into  the  woods.  Besides,  with  the  help  of  his  sister,  he 
proved  an  alibi.  The  untiring  efforts  of  the  officei's  brought  new  evi- 
dence to  light,  and  finally  E.  confessed.  He  had  enticed  the  girl  into 
the  woods,  thrown  her  down,  exposed  her  genitals,  and  was  about  to 
abuse  her ;  but,  as  she  had  an  eruption  on  her  head,  and  was  crying 
loudly,  his  desire  cooled,  and  he  fled. 

After  he  enticed  the  boy  into  the  woods,  with  the  pretext  of  show- 


*  Comp.  the  cases  of  Tardieu,  Attentats,  p.  182-192. 
3  Comp.  Haltzendorff,  Psychologie  des  Mords. 
3  Tardieu,  Attentats,  Case  51,  p.  188. 


LUST-MURDER.  399 

ing  him  a  bird's  nest,  he  was  taken  with  a  desire  to  abuse  him.  Since 
the  bo3r  refused  to  take  off  his  trousers,  he  did  it  for  him;  and  when 
the  boy  began  to  cry  out,  he  stabbed  him  twice  in  the  neck.  Then  he 
made  an  incision,  just  above  the  pubes,  in  imitation  of  female  genitals, 
in  order  to  use  it  to  satisfy  his  lust.  But,  since  the  body  grew  cold 
immediately,  he  lost  his  desire,  and,  cleaning  his  knife  and  hands  near 
the  body,  he  fled.  When  he  saw  the  boy  dead,  he  was  filled  with  fear, 
and  his  limbs  became  weak. 

During  his  examination  E.  looked  apathetically  at  a  garland.  He 
had  acted  in  a  state  of  mental  weakness.  He  could  not  understand  how 
he  came  to  do  such  a  thing.  He  must  have  been  beside  himself;  for  he 
often  became  senseless,  so  that  he  would  almost  fall  down.  Previous 
emplojers  report  that  he  had  periods  when  he  was  devoid  of  thought 
and  confused,  doing  no  work  all  day,  and  avoiding  others.  His  father 
states  that  E.  learned  with  difficulty,  was  unskillful  at  work,  and  often 
so  obstinate  that  one  did  not  think  to  punish  him.  At  such  times  he 
would  not  eat,  and  occasionally  ran  away  and  remained  all  day.  At 
such  times  he  also  seemed  quite  lost  in  thought,  screwed  his  face  up, 
and  said  senseless  things.  When  quite  a  boy,  he  still  sometimes  wet 
the  bed,  and  often  came  home  from  school  with  wet  or  soiled  clothing. 
He  was  very  restless  in  sleep,  so  that  no  one  could  sleep  beside 
him.  He  had  never  had  playmates.  He  had  never  been  cruel,  bad,  or 
immoral. 

His  mother  gave  similar  testimon}' ;  and  further,  that,  fn  his  fifth 
year,  E.  first  had  convulsions,  and  once  lost  the  power  of  speech  for 
seven  days.  Sometime  about  his  seventh  jear  he  once  had  convul- 
sions for  forty  days,  and  was  also  dropsical.  Later,  too,  he  was  often 
seized  in  sleep,  and  he  often  then  talked  in  his  sleep ;  and  mornings, 
after  such  nights,  the  bed  was  found  wet. 

At  times  it  was  impossible  to  do  anything  with  him.  Since  his 
mother  did  not  know  whether  it  was  due  to  viciousness  or  disease,  she 
did  not  venture  to  punish  him. 

Since  his  convulsions,  in  his  seventh  year,  he  had  failed  so  in  mind 
that  he  could  not  learn  even  the  common  prayers';  and  he  also  became 
very  irascible. 

Neighbors,  persons  prominent  in  the  community,  and  teachers 
state  that  E.  was  peculiar,  weak-minded,  and  irascible;  that  at  times  he 
was  very  strange,  and  apparently  in  an  exceptional  mental  state. 

The  examinations  of  the  medical  experts  gave  the  following 
results : — 

E.  is  tall,  slim,  and  poorly  nourished.  His  head  measures  53  centi- 
metres in  circumference.  The  cranium  is  rhombic,  and  in  the  occipital 
region  flattened. 

His  expression  is  devoid  of  intelligence ;  his  glance  is  fixed, 
expressionless ;  his  attitude  is  careless,  and  his  body  is  bent  forward. 


400  PSYCHOPATHIA    SEXUALIS. 

Movements  are  slow  and  heavy.  Genitals  normally  developed.  E.'s 
whole  appearance  points  to  torpidity  and  mental  weakness. 

There  are  no  signs  of  degenerative  marks,  no  abnormality  of  the 
vegetative  organs,  and  no  disturbances  of  motility  or  sensibility.  He 
comes  of  a  perfectly  healthy  family.  He  knows  nothing  of  convulsions 
or  of  wetting  his  bed  at  night,  but  he  states  that,  of  late  years,  he  has 
had  attacks  of  vertigo  and  loss  of  mind. 

At  first,  in  circumlocution,  he  denies  the  murder.  Later,  in  great 
contrition,  before  the  examining  judge,  he  confessed  all,  and  gave  a 
clear  motive  for  his  crime.     He  had  never  had  such  a  thought  before. 

He  has  been  given  to  onanism  for  years ;  he  even  practiced  it  twice 
daily.  He  states  that,  for  want  of  courage,  he  had  never  ventured  to 
ask  coitus  of  a  woman,  though  in  dreams  such  scenes  exclusively  passed 
before  him.  Neither  in  dreams  nor  in  the  waking  state  had  he  ever  had 
perverse  instincts  ;  particularly  no  sadistic  or  contrary  sexual  feelings. 
Too,  the  sight  of  the  slaughter  of  animals  had  never  interested  him. 
When  he  enticed  the  girl  into  the  woods,  his  desire  was  to  satisfy  his 
lust  with  her ;  but  how  it  happened  that  he  tried  such  a  thing  with  a 
boy,  he  could  not  explain.  He  thought  he  must  have  been  out  of  his 
mind  at  that  time.  The  night  after  the  murder  he  could  not  sleep  on 
account  of  fear;  he  had  twice  confessed  already,  to  ease  his  conscience. 
He  was  only  afraid  of  being  hung.  This  should  not  be  done,  as  he 
had  done  the  deed  in  a  weak-minded  condition. 

He  could  not  tell  why  he  had  cut  open  the  boy's  abdomen.  It  had 
not  occurred  to  him  to  handle  the  intestines,  smell  them,  etc.  He  stated 
that,  after  the  attempt  on  the  girl  in  the  day-time,  and  in  the  night,  after 
the  murder  of  the  boy,  he  had  convulsions.  At  the  time  of  his  crime  he 
was  indeed  conscious,  but  he  had  not  thought  at  all  of  what  he  did.' 

He  suffered  much  with  headache;  could  not  endure  heat,  thirst,  or 
alcohol ;  there  were  times  when  he  was  perfectly  confused.  The  test  of 
his  intelligence  showed  a  high  grade  of  weak-mindedness. 

The  opinion  (Dr.  Kautzner,  of  Graz)  showed  the  imbecility  and 
neurosis  of  the  accused,  and  made  it  probable  that  his  crime,  for  which 
he  had  only  a  general  recollection,  had  been  committed  in  an  exceptional 
(pne-epileptic)  mental  state,  conditioned  by  the  neurosis.  Under  all 
circumstances,  E.  was  considered  dangerous,  and  probably  would  require 
commitment  to  an  asylum  for  life. 


SADISM   AND   FETICHISM.  401 

3.  Bodily  Injury,  Injury  to  Property,  and  Torture  op  Animals 

Dependent  on  Sadism.1 
(Austrian,  §  152,  411;  German,  §  223  [bodily  injury].     Austrian,  §  85, 
468;  German,  §  303  [injury  to  property].     Austrian  Police  Regula- 
tions; German  Statutes,  §  360  [torture  of  animals].) 
Aside  from  lust-murder,  described  in  the  foregoing  section, 
as   milder   expressions   of    sadistic   desires,   impulses   to    stab, 
flagellate,   or   defile   females,    to   flagellate   boys,    to   maltreat 
animals,  etc.,  also  occur.  / 

The  deep  degenerative  significance  of  such  cases  is  clearly 
demonstrated  by  the  series  of  examples  given  under  "  General 
Pathology."  Such  mentally  degenerate  individuals,  should  they 
be  unable  to  control  their  perverse  impulses,  could  only  be 
objects  of  care  in  asylums. 

4.  Bodily  Injury,  Robbery,  and  Theft  Dependent  on  Fetichism. 
(Austrian,  §  190  ;  German,  §  249  [robbery].     Austrian,  §  171,  460; 

German,  §  242  [theft].) 

It  is  seen  from  the  section  on  fetichism,  under  "  General 
Pathology,"  that  pathological  fetichism  may  become  the  cause 
of  crimes.  There  are  now  recognized,  as  such,  hair-despoiling 
(Cases  78,  79,  80);  robbery  or  theft  of  female  linen,  handker- 
chiefs, aprons  (Cases  82,  83,  85,  86),  shoes  (Cases  68,  87,  88), 
and  silks  (Case  93).  It  cannot  be  doubted  that  such  individuals 
are  subjects  of  deep  mental  taint.  But,  for  the  assumption  of  an 
absence  of  mental  freedom  and  consequent  irresponsibility,  it 

1  Masochism  may,  under  certain  circumstances,  attain  forensic  importance.  Modern 
criminal  law  no  longer  recognizes  the  principle,  "  volenti  non  fit  injuria"  ;  and  the  present 
Austrian  statute,  in  §  4,  says  expressly  :  "  Crimes  may  also  he  committed  on  persons  who 
demand  their  commission  on  themselves." 

As  Herbst  (Handb.  d.  osterr.  Strafrechts.,  Wien,  1878,  p.  72)  remarks,  there  are, 
nevertheless,  crimes  conditioned  by  the  absence  of  assent  on  the  part  of  the  injured  indi- 
vidual, which  cease  to  be  such  as  soon  as  the  injured  individual  has  given  consent, — e.g., 
theft,  rape. 

But  Herbst  also  enumerates  here  the  limitation  of  personal  freedom  (?). 

Of  late  a  decided  change  of  views  on  this  point  has  taken  place.  The  German 
criminal  law  regards  the  consent  of  a  man  to  his  own  death  of  6uch  importance  that  a  very 
different  and  much  milder  punishment  is  inflicted  under  such  circumstances  (§  216)  ;  and 
it  is  the  same  in  Austrian  law  (Austrian  Abridgment,  §  222).  The  so-called  double 
suicide  of  lovers  was  the  act  considered.  In  bodily  injury  and  deprivation  of  freedom,  the 
consent  of  the  victim  must  also  receive  consideration  at  the  hands  of  the  judge.  Certainly 
a  knowledge  of  masochism  is  of  importance  in  making  a  judgment  of  the  probability  of 
asserted  consent. 


402  PSYCHOPATHIA   SEXUALIS. 

must  be  proved  that  there  was  an  irresistible  impulse,  which, 
either  owing  to  the  strength  of  the  impulse  itself,  or  to  the 
existence  of  mental  weakness,  made  control  of  the  punishable, 
perverse  impulsion  impossible.  Such  crimes  and  the  peculiar 
manner  in  which  they  are  performed, — in  which  they  differ  very 
much  from  common  robbery  and  theft, — always  demand  a 
medico-legal  examination.  But  that  the  act  per  se  does  not,  by 
any  means,  necessarily  arise  from  psycho-pathological  conditions 
is  shown  by  the  infrequent  cases  of  hair-despoiling  '  simply  for 
the  purpose  of  gain. 

5.  Violation  op  Individuals  Under  the  Age  of  Fourteen. 

(Austrian  Statutes,  §  128,  132;  Austrian  Abridgment,  §  189,  1913; 
German  Statutes,  §  174,  1763.) 

By  violation  of  sexually  immature  individuals,  the  jurist 
understands  all  the  possible  immoral  acts  with  persons  under 
fourteen  years  of  age  that  are  not  comprehended  in  the  term 
rape.  The  term  violation,  in  the  legal  sense  of  the  word,  com- 
prehends the  most  horrible  perversions  and  acts,  which  are 
possible  only  to  a  man  who  is  controlled  by  lust  and  morally 
weak,  and,  as  is  usually  the  case,  lacking  in  sexual  power. 

A  common  feature  of  these  crimes,  committed  on  persons 
that  are  more  or  less  children,  is  that  they  are  unmanly,  childish, 
and  often  silly.  It  is  a  fact  that  such  acts,  with  exceptions  in 
pathological  cases,  like  those  of  imbeciles,  paretics,  and  senile 
dements,  are  almost  exclusively  committed  by  young  men  who 
lack  courage  or  have  no  faith  in  their  virility;  or  by  roues 
who  have,  to  some  extent,  lost  their  virility.  It  is  psychologi- 
cally incomprehensible  that  an  adult  of  full  virility,  and  mentally 
sound,  should  indulge  in  sexual  abuses  with  children. 

The  imagination  of  debauchees,  in  actively  or  passively 
picturing  the  immoral  acts,  is  exceedingly  lively  ;  and  that  the 
following  enumeration  of  the  sexual  acts  of  this  kind  known  to 
law  exhausts  all  the  possibilities  is  questionable.  Most  fre- 
quently the   abuse  consists  of  sexual   handling  (under  some 

1  According  to  Austrian  law,  this  crime  should  fall  under  §411,  as  slight  bodily 
injury ;  according  to  the  German  criminal  law,  it  is  bodily  injury  (comp.  Liszt,  p.325). 


VIOLATION.  403 

circumstances,  flagellation *),  active  marmstupration,  or  seducing 
children  by  inducing  them  to  perform  onanism,  or  lustful  hand- 
ling, on  the  seducer.  Less  frequent  acts  are  cunnilingus,  irru- 
mare  on  boys  or  girls,  psedicatio  puellarum,  coitus  inter  femora, 
and  exhibition. 

In  a  case  which  Maschka  reports  ("  Handb.,"  iii,  p.  174),  a  young 
man  had  naked  girls,  from  eight  to  twelve  years  old,  dance  about  in  his 
room,  and  urinate  before  him,  until  he  ejaculated.  Not  infrequently  boys 
are  abused  by  sensual  women,  who  undertake  to  bring  about  conjunctio 
membrorum  with  them,  in  order  to  satisfy  themselves  b}r  means  of 
friction  or  onanism.2 

Tardieu  saw  one  of  the  most  disgusting  examples.  A  servant,  in 
company  with  her  lover,  masturbated  children  intrusted  to  them,  per- 
formed cunnilingus  with  a  girl  of  seven,  and  introduced  parsnips  and 
potatoes  into  her  vagina,  and  put  similar  things  into  the  rectum  of  a 
baby  of  two  years  ! 

Case  185.  Z.,  aged  62  ;  deeply  tainted,  masturbator.  He  states  he 
has  never  had  coitus,  but  has  frequently  practiced  fellatio.  He  is  in  an 
asylum,  on  account  of  paranoia.  It  had  been  his  greatest  pleasure  to 
entice  girls,  aged  from  ten  to  fourteen  years,  and  practice  cunnilingus 
and  other  vile  acts  with  them.  In  these  acts  he  had  orgasm  and  ejacu- 
lation. Masturbation  did  not  give  him  the  same  satisfaction,  and  induced 
ejaculation  only  with  difficulty.  Faute  de  mieux  he  also  practiced  fel- 
latio with  men  ;  occasionally  an  exhibitionist.  Phimosis  ;  asymmetrical 
cranium.     (Pelanda,  Arch,  di  Psichiatria,  x,  fascic.  3,  4.) 

Case  186.  X.,  priest,  aged  40.  He  was  accused  of  enticing  girls,  aged 
from  ten  to  thirteen,  undressing  and  fondling  them  lustfully,  and  finally 
masturbating.  He  is  tainted,  and  has  been  an  onanist  from  childhood  ; 
morally  imbecile;  alwa}rs  very  excitable  sexually.  Head  somewhat  small. 
Penis  unusually  large  ;  indications  of  hypospadiasis.    (Pelanda,  loc.  cit.) 

Case  187.  K.,  aged  23 ;  laborer.  He  was  accused  and  convicted 
of  repeatedly  enticing  boys,  and  now  and  then  girls,  to  an  out-of-the- 
way  place,  and  practicing  abuses  with  them  (mutual  masturbation, 
fellatio  puerorum,  fondling  of  the  genitals  of  the  girls). 

K.  is  an  imbecile,  and  physically  deformed,  being  scarcely  1.5 
metres  tall ;  cranium  rachitic  and  hydrocephalic  ;  teeth  bad, — furrowed, 
defective,  and  irregular.  Large  lips,  idiotic  expression,  stuttering 
speech,  and  an  awkward  attitude  complete  the  picture  of  psycho- 
physical degeneration.  K.  behaves  like  a  child  discovered  in  some 
mischievous  act.      Scarcely  any  growth  of  beard.      Genitals  well  and 

1  Cases,  vide  Friedreich's  Blatter  f.  ger.  Anthropologic,  iii,  p.  77. 

2  Cases,  Maschka,  Handb.,  iii,  p.  175. — Casper,  Vierteljahrsschr.,  1852,  Bd.  i,—» 
Tardieu,  Attentats, 


404  PSYCHOPATHIA   SEXUALIS. 

normally  developed.  He  has  a  superficial  consciousness  of  having  done 
something  improper,  but  he  is  unconscious  of  the  moral,  social,  and 
legal  significance  of  his  crimes. 

K.  comes  of  a  drunken  father,  and  a  mother  who  became  insane 
from  the  abuse  of  her  husband,  and  died  in  an  asylum.  In  his  baby* 
hood  the  boy  was  almost  blinded  by  corneal  ulcers,  and,  after  his  sixth 
year,  he  grew  up  with  an  almoner,  and  later  with  difficulty  enrned  his 
living  as  an  organ-grinder.  His  brother  is  good  for  nothing,  and  the 
culprit  himself  was  considered  a  surly,  quarrelsome,  evil,  moody,  irri- 
table man.  The  opinion  emphasized  the  intellectual,  moral,  and  physical 
defect  of  the  culprit. 

Unfortunately  it  must  be  admitted  that  the  most  revolting  of 
these  crimes  are  done  by  sane  individuals  who,  by  reason  of  satiety 
in  normal  sexual  indulgence,  lasciviousness,  and  brutality,  and  not 
seldom  during  intoxication,  forget  that  they  are  human  beings. 

A  great  number  of  these  cases,  however,  certainly  depend 
upon  pathological  states.  This  is  particularly  true  where  old 
men  become  the  seducers  of  children.1 

1  agree  with  Kirn,  who,  under  all  circumstances,  in  cases 
of  this  kind,  holds  a  mental  examination  to  be  always  necessary ; 
since,  frequently  enough,  a  re-awakened,  perverse,  abnormally 
intense,  and  uncontrolable  sexual  desire  is  shown  to  be  one  of 
the  manifestations  of  a  senile  dementia. 

6.  Unnatural  Abuse — Sodomy.2 

(Austrian  Statutes,  §  129  ;  Abridgment,  §  190  ;  German  Statutes,  §  175.) 

(a)    Violation  of  Animals — Bestiality.3 

Violation  of  animals,  monstrous  and  revolting  as  it  seems 

to  mankind,  is  by  no  means  always  due  to  psycho-pathological 

*  Comp.  Kirn,  Allg.  Zeitschr.  f.  Psych.,  39,  p.  217. 

2  I  follow  the  usual  terminology  in  describing  bestiality  and  pederasty  under  the 
general  term  sodomy.  In  Genesis  (chap,  xix),  whence  this  word  comes,  it  signifies  exclu- 
sively the  vice  of  pederasty.  Later,  sodomy  was  often  used  synonymously  with  bestiality. 
The  moral  theologians,  like  St.  Alphons  of  Liguori,  Gury,  and  others,  have  always  distin- 
guished correctly,  i.e.,  in  the  sense  of  Genesis,  between  sodomia,  i.e.,concubituscum  persona 
ejusdem  sexus,  and  bestialitas,  i.e.,  concubitus  cum  bestia  (comp.  Olfus,  Pastoralmedicin, 
p.  78). 

The  jurists  brought  confusion  into  the  terminology  by  establishing  a  "  Sodomia 
ratione  sexus"  and  a"  S.  ratione  generis."  Science,  however,  should  assert  itself  as 
ansilla  theologke,  and  return  to  the  correct  usage. 

3  For  interesting  histories,  vide  Krauss,  Psychol,  d.  Verbrechens,  p.  180. — Maschka, 
Hdb.  iii,  p.  188. — Hofmann,  Lehrb.  d.  ger.  Med.,  p.  180. — Rosenbaum,  Die  Lustseuche. 


UNNATURAL   ABUSE — SODOMY.  405 

conditions.  Low  morality  and  great  sexual  desire,  with  lack 
of  opportunity  of  natural  indulgence,  are  the  principal  motives 
of  this  unnatural  means  of  sexual  satisfaction,  which  is  resorted 
to  by  women  as  well  as  by  men. 

To  Polak  we  owe  the  knowledge  that  in'  Persia  bestiality  is  fre- 
quently practiced  because  of  the  delusion  that  it  cures  gonorrhoea;  just 
as  in  Europe  an  idea  is  still  prevalent  that  intercourse  with  children 
heals  venereal  disease. 

Experience  teaches  that  bestiality  with  cows  and  horses  is  none 
too  infrequent.  Occasionally  the  acts  may  be  undertaken  with  goats, 
bitches,  and,  as  a  case  of  Tardieu's  and  one  by  Schauenstein  show 
(Lehrb.,  p.  125),  with  hens. 

The  action  of  Frederick  the  Great,  in  the  case  of  a  cavalryman  who 
had  committed  bestiality  with  a  mare,  is  well  known  :  "  The  fellow  is  a 
beast,  and  shall  be  reduced  to  the  infantry." 

The  intercourse  of  females  with  beasts  is  limited  to  dogs.  A  mon- 
strous example  of  the  moral  depravity  in  large  cities  is  related  by 
Maschka  ("  Handb.,"  iii), — the  case  of  a  Parisian  female  who  showed 
herself  in  the  sexual  act  with  a  trained  bull-dog,  to  a  secret  circle  of 
roues,  at  10  francs  a  head. 

There  has  been,  heretofore,  but  little  legal  consideration  of 
the  mental  condition  in  those  given  to  violation  of  animals.  In 
several  cases  known  to  the  writer,  the  individuals  were  weak- 
minded.     In  Schauenstein's  case  there  was  insanity. 

The  following  case  of  bestiality  is  one  that  was  certainly 
conditioned  by  disease.  He  was  an  epileptic.  In  this  case  the 
desire  for  animals  appeared  as  an  equivalent  of  the  normal 
sexual  desire : — 

Case  188.  X.,  peasant,  aged  40;  Greek-Catholic.  Father  and 
motner  were  hard  drinkers.  Since  his  fifth  year  patient  has  had  epilep- 
tic convulsions, — t.c,  he  falls  down  unconscious,  lies  still  two  or  three 
minutes,  and  then  gets  up  and  runs  wildly  about  with  staring  eyes.  Sex- 
uality was  first  manifested  at  seventeen.  The  patient  had  inclinations 
neither  for  women  nor  for  men,  but  for  animals  (birds,  horses,  etc.).  He 
had  intercourse  with  hens  and  ducks,  and  later  with  horses  and  cows. 
Never  any  onanism. 

The  patient  paints  pictures  of  saints ;  is  of  very  limited  intelligence. 
For  years,  religious  paranoia,  with  states  of  ecstasy.  He  has  an  "  un- 
speakable "  love  for  the  Virgin,  for  whom  he  would  sacrifice  his  life.  Taken 
to  hospital,  he  proves  to  be  free  from  infirmity  and  signs  of  degeneration. 


406  PSYCHOPATHIA   SEXUALIS. 

He  had  always  had  an  aversion  for  women.  In  a  single  attempt  at 
coitus  with  a  woman  he  was  impotent,  but  with  animals  lie  was  always 
potent.  He  is  ashamed  before  women  ;  coitus  with  women  he  regards 
almost  as  a  sin.     (Kowalewsky,  Jahrb.  f.  Psychiatrie,  vii,  Heft  3.) 

Case  189.  On  the  afternoon  of  September  23,  1889,  W.,  aged  16, 
shoe-maker's  apprentice,  caught  a  goose  in  a  neighbor's  garden,  and 
committed  bestiality  on  the  fowl  until  the  neighbor  approached.  On 
being  accused  by  the  neighbor,  W.  said,  "  Is  there  anything  wrong  with 
the  goose?"  and  then  went  away.  At  his  examination  he  confessed  the 
act,  but  excused  himself  on  the  ground  of  temporary  loss  of  mind. 
Since  a  severe  illness,  in  his  twelfth  year,  he  several  times  a  month  had 
attacks,  with  heat  in  his  head,  in  which  he  was  intensely  excited  sex- 
ually, could  not  help  himself,  and  did  not  know  what  he  did.  He  had 
done  the  act  in  such  an  attack.  He  answered  for  himself  in  the  same 
way  at  the  trial,  and  stated  that  he  knew  nothing  of  the  species  facti 
except  from  the  statements  of  the  neighbor.  His  father  states  that  W., 
who  comes  of  a  healthy  family,  has  alwaj^s  been  sickly  since  an  attack  of 
scarlatina  in  his  fifth  year,  and  that,  at  the  age  of  twelve,  he  had  a  febrile 
cerebral  disease.  W.  had  a  good  reputation,  learned  well  in  school,  and, 
later,  helped  his  father  in  his  work.     He  was  not  given  to  masturbation. 

The  medical  examination  revealed  no  intellectual  or  moral  defect. 
The  physical  examination  revealed  normal  genitals;  penis  relatively 
greatly  developed ;  marked  exaggeration  of  the  patellar  reflexes.  In 
other  respects,  negative  result. 

The  history  of  the  condition  at  the  time  of  the  deed  was  not  to  be  de- 
pended upon.  There  was  no  history  of  previous  attacks  of  mental  disturb- 
ance, and  there  were  none  during  the  six  weeks  of  observation.  There  was 
no  perversion  of  the  vita  sexualis.  The  medical  opinion  allowed  the  pos- 
sibility that  some  organic  cause  (cerebi-al  congestion),  dependent  upon 
cerebral  disease,  may  have  exercised  an  influence  at  the  time  of  the  commis- 
sion of  the  criminal  act.     (From  the  opinion  of  Dr.  Fritsch,  of  Vienna.) 

Case  190.  Impulsive  Sodomy. — A.,  aged  16;  gardener's  boy;  born 
out  of  wedlock;  father,  unknown ;  mother,  deeply  tainted,  hystero-epi- 
leptic.  A.  has  a  deformed,  asymmetrical  cranium,  and  deformity  and 
asymmetry  of  the  bones  of  the  face ;  the  whole  skeleton  is  also  deformed, 
as3rm metrical,  and  small.  From  childhood  he  was  a  masturbator ;  always 
morose,  apathetic,  and  fond  of  solitude;  veiy  irritable,  and  pathological 
in  his  emotional  reaction.  He  is  imbecile,  probably  much  reduced  phys- 
ically by  masturbation,  and  neurasthenic.  Besides,  he  presents  hystero- 
pathic  S3rmptoms  (limitation  of  the  visual  field,  dyschromatopsia ;  dimi- 
nution of  the  senses  of  smell,  taste,  and  hearing  on  the  right  side; 
anaesthesia  of  the  right  testicle,  clavus,  etc.). 

A.  is  convicted  of  having  committed  masturbation  and  sodomy  on 
dogs  and  rabbits.  When  twelve  years  old  he  saw  how  boys  masturbated 
a  dog.     He  imitated  it,  aiid  thereafter  he  could  not  keep  from  abusing 


UNNATURAL  ABUSE — SODOMY.  407 

dogs,  cats,  and  rabbits  in  this  vile  manner.  Much  more  frequently,  how- 
ever, he  committed  sodomy  on  female  rabbits, — the  only  animal  that  had 
a  charm  for  him.  At  dusk  he  was  accustomed  to  repair  to  his  master's 
rabbit-pen,  in  order  to  gratify  his  vile  desire.  Rabbits  with  torn  rectums 
were  repeatedly  found.  The  act  of  bestiality  was  always  done  in  the 
same  manner.  There  were  actual  attacks  which  came  on  every  eight 
weeks,  alwaj'S  in  the  evening,  and  always  in  the  same  way.  A.  would 
become  very  uncomfortable,  and  have  a  feeling  as  if  some  one  were 
pounding  his  head.  He  felt  as  if  losing  his  reason.  He  struggled 
against  the  imperative  idea  of  committing  sodomy  with  the  rabbits,  and 
thus  had  an  increasing  feeling  of  fear  and  intensification  of  headache, 
until  it  became  unbearable.  At  the  height  of  the  attack  there  was  sound 
of  bells,  cold  perspiration,  trembling  of  the  knees,  and,  finally,  loss  of 
resistive  power,  and  impulsive  performance  of  the  perverse  act.  As  soon 
as  this  was  done,  he  lost  all  anxiety ;  the  nervous  C3^cle  was  completed, 
and  he  was  again  master  of  himself,  deeply  ashamed  of  the  deed,  and 
fearful  of  the  return  of  an  attack.  A.  states  that,  in  such  a  condition, 
if  called  upon  to  choose  between  a  woman  and  a  female  rabbit,  he  could 
make  choice  only  of  the  latter.  In  the  intervals,  of  all  domestic  animals, 
he  is  partial  only  to  rabbits.  In  his  exceptional  states  simple  caressing 
or  kissing,  etc.,  of  the  rabbit  suffices,  as  a  rule,  to  afford  him  sexual  satis- 
faction ;  but  sometimes  he  has,  when  doing  this,  such  furor  sexnalis  that 
he  is  forced  to  wildly  perform  sodomy  on  the  animal. 

The  acts  of  bestiality  mentioned  are  the  only  acts  which  afford  him 
sexual  satisfaction,  and  they  constitute  the  only  manner  in  which  he  is 
capable  of  sexual  indulgence.  A.  states  that,  in  the  act,  he  never  had  a 
lustful  feeling,  but  satisfaction,  inasmuch  as  he  was  thus  freed  from  the 
painful  condition  into  which  he  was  brought  by  the  imperative  impulse. 

The  medical  evidence  easily  proved  that  this  human  monster  was  a 
psychically  degenerate,  irresponsible  invalid,  and  not  a  criminal.  (Boe- 
teau,  La  France  medicale,  38th  year,  No.  38.) 

The  following  case  seems  to  be  devoid  of  a  psychopathic 
basis : — 

Case  191.  Sodomy. — In  a  provincial  town  a  man  was  caught  in 
intercourse  with  a  hen.  He  was  thirty  years  old,  and  of  high  social 
position.  The  chickens  had  been  dying  one  after  another,  and  the  man 
causing  it  had  been  searched  for  a  long  time.  To  the  question  of  the 
judge,  as  to  the  reason  for  such  an  act,  the  accused  said  that  his  genitals 
were  so  small  that  coitus  with  women  was  impossible.  Medical  exam- 
ination showed  that  the  genitals  were  actually  extremely  small.  The 
man  was  mentally  entirely  sound. 

There  were  no  statements  concerning  anjr  abnormalities  at  the  time 
of  puberty,  etc.     (Gyurkovechky,  "  Mannl.  Impotenz,"  1889,  p.  82.) 


408  PSYCHOPATHIA   SEXUALIS. 

(b)  With  Persons  of  the  Same  Sex — Pederasty  ;  Sodomy  in  its  Strict 

Sense. 

German  law  takes  cognizance  of  unnatural  sexual  relations 
only  between  men ;  Austrian,  between  those  of  the  same  sex ; 
and,  therefore,  unnatural  relations  between  women  are  punish- 
able. 

Among  the  immoralities  between  men,  pederasty  (immissio 
penis  in  anum)  claims  the  principal  interest.  Indeed,  the  jurist 
thought  only  of  this  perversity  of  sexual  activity ;  and,  accord- 
ing to  the  opinions  of  distinguished  interpreters  of  the  law 
(Oppenhoff,  "  Stgsb.,"  Berlin,  1872,  p.  324,  and  Rudolf  and 
Stenglein,  "  D.  Strafgesb.  f.  d.  Deutsche  Reich,"  1881,  p.  423), 
immissio  penis  in  corpus  vivum  belongs  to  the  criminal  act 
covered  by  §  175. 

According  to  this  interpretation,  legal  punishment  would 
not  follow  other  improper  acts  between  male  persons,  so  long  as 
they  were  not  complicated  with  offense  to  public  decency,  with 
force,  or  undertaken  with  boys  under  the  age  of  fourteen.  Of 
late  this  interpretation  has  again  been  abandoned,  and  the  crime 
of  unnatural  abuse  between  men  has  been  assumed  when  merely 
acts  similar  to  cohabitation  were  performed.1 

The  study  of  contrary  sexual  instinct  has  placed  male  love 
of  males  in  a  very  different  light  from  that  in  which  it,  and 
particularly  pederasty,  stood  at  the  time  the  statutes  were 
framed.  The  fact  that  there  is  no  doubt  about  the  pathological 
basis  of  many  cases  of  contrary  sexual  instinct  shows  that 
pederasty  may  also  be  the  act  of  an  irresponsible  person,  and 
makes  it  necessary,  in  court,  to  examine  not  merely  the  deed, 
but  also  the  mental  condition  of  the  perpetrator. 

The  principles  laid  down  previously  must  also  be  adhered 
to  here.  Not  the  deed,  but  only  an  anthropological  and  clinical 
judgment   of    the   perpetrator    can    permit   a   decision   as  to 

1  How  difficult,  unpleasant,  and  dangerous  for  the  jurist  judgment  of  these  "  coitus- 
like "  acts  for  the  establishment  of  the  objective  fact  of  the  crime  may  be  is  well  shown 
by  an  article  on  the  punish ableness  of  male  intercourse,  in  the  Zeitschr.  f.  d.  gesammte 
Strafrechtswissenschaft.,  Bd.  vii,  Heft  1,  as  well  as  by  a  similar  one  in  Friedreich's 
Blatter  f.  ger.  Medicin,  1891,  Heft  6.  Vide,  further,  Moll,  Contrare  Sexualempfindung, 
p.  223  et  seq.,  and  Bernhardi,  Der  Uranismus,  Berlin,  1882. 


UNNATURAL   ABUSE — SODOMY.  409 

whether  we  have  to  do  with  a  perversity  deserving  punishment, 
or  with  an  abnormal  perversion  of  the  mental  and  sexual  life, 
which,  under  certain  circumstances,  excludes  punishment.  The 
next  legal  question  to  settle  is  whether  the  contrary  sexual  feeling 
is  congenital  or  acquired ;  and,  in  the  latter  case,  whether  it  is 
abnormal  perversion  or  moral  perversity. 

Congenital  contrary  sexual  instinct  occurs  only  in  predis- 
posed (tainted)  individuals,  as  a  partial  manifestation  of  a 
defect  evidenced  by  anatomical  or  functional  abnormalities,  or 
both.  The  case  becomes  clearer,  and  the  diagnosis  more  certain, 
if  the  individual,  in  character  and  disposition,  seems  to  correspond 
entirely  with  his  sexual  peculiarity;  and  if  the  inclination 
toward  persons  of  the  opposite  sex  is  entirely  wanting,  and 
horror  of  sexual  intercourse  with  them  is  felt ;  and  if  the  indi- 
vidual, in  the  impulses  to  satisfy  the  contrary  sexual  instinct, 
shows  other  anomalies  of  the  sexual  sphere,  such  as  more  pro- 
nounced degeneration  in  the  form  of  periodicity  of  the  impulse 
and  impulsive  conduct,  and  is  a  neuropathic  and  psychopathic 
person. 

Another  question  concerns  the  mental  condition  of  the 
urning.  If  this  be  such  as  to  remove  the  possibility  of  moral 
responsibility,  then  the  pederast  is  not  a  criminal,  but  an  irre- 
sponsible insane  person.  This  condition  in  congenital  urnings 
is  apparently  less  frequent  than  another.  As  a  rule,  these  cases 
present  elementary  psychical  disturbances,  which  do  not  remove 
responsibility.  But  this  does  not  settle  the  question  of  the 
responsibility  of  the  urning.  The  sexual  instinct  is  one  of  the 
most  powerful  organic  needs.  There  is  no  law  that  looks  upon 
its  satisfaction  outside  of  marriage  as  punishable  in  itself;  if 
the  urning  feels  perversely,  it  is  not  his  fault,  but  the  fault  of  a 
condition  natural  to  him.  His  sexual  instinct  may  be  aestheti- 
cally very  repugnant,  but,  from  his  stand-point,  it  is  natural. 
And,  too,  in  the  majority  of  these  unfortunates,  the  perverse 
sexual  instinct  is  abnormally  intense,  and  their  consciousness 
recognizes  it  as  nothing  unnatural.  Thus  they  fail  to  have 
moral  and  aesthetic  ideas  to  assist  them  in  resisting  the  instinct. 
Innumerable  normally  constituted    men   are  in  a  position  to 


410  PSTCHOPATHIA   SEXTTALIS. 

overcome  the  desire  for  satisfaction  of  their  libido  without  suffer- 
ing from  it  in  health.  Many  neuropathic  individuals, — and 
urnings  are  almost  always  neuropathic, — on  the  contrary,  become 
nervously  ill  when  they  do  not  satisfy  the  sexual  desire,  either 
as  Nature  prompts  or  in  a  way  that  is  for  them  perverse. 

The  majority  of  urnings  are  in  a  painful  situation.  On 
the  one  hand,  there  is  an  impulse  toward  persons  of  their  own 
sex  that  is  abnormally  intense,  the  satisfaction  of  which  has  a 
good  effect,  and  is  natural  to  them  ;  on  the  other,  is  public 
sentiment  which  stigmatizes  their  acts,  and  the  law  which 
threatens  them  with  punishment.  Before  them  lies  mental 
despair, — even  insanity  and  suicide, — at  the  very  least,  nervous 
disease ;  behind  them,  shame,  loss  of  position,  etc.  It  cannot 
be  doubted  that,  under  these  circumstances,  states  of  necessity 
and  compulsion  may  be  created  by  the  unfortunate  natural 
disposition  and  constitution.  Society  and  the  law  should  under- 
stand these  facts.  The  former  must  pity,  and  not  despise,  such 
unfortunates ;  the  latter  must  cease  to  punish  them, — at  least, 
while  they  remain  within  the  limits  which  are  set  for  the  activity 
of  their  sexual  instinct. 

As  a  confirmation  of  these  opinions  and  demands  concerning  these 
step-children  of  Nature,  it  is  permissible  to  reproduce  here  the  memorial 
of  an  urning  to  the  author.  The  writer  of  the  following  lines  is  a  man 
of  high  position  in  London  : — 

"  You  have  no  idea  what  a  constant  struggle  we  all — particularly 
those  of  us  that  have  the  most  mind  and  finest  feelings — have  to  endure, 
and  how  we  suffer  under  the  prevailing  false  ideas  about  us  and  our 
so-called  immorality. 

. "  Your  opinion  that  the  phenomenon  under  consideration  is  pri- 
marily due  to  a  congenital '  pathological '  disposition  will,  perhaps,  make 
it  possible  to  overcome  existing  prejudices,  and  awaken  pitj*  for  poor, 
1  abnormal '  men,  instead  of  the  present  repugnance  and  contempt.  Much 
as  I  believe  that  the  opinion  expressed  by  j'ou  is  exceedingly  beneficial 
to  us,  I  am  still  compelled,  in  the  interest  of  science,  to  repudiate  the 
word  '  pathological' ;  and  }rou  will  permit  me  to  express  a  few  thoughts 
with  respect  of  it. 

"  Under  all  circumstances  the  phenomenon  is  anomalous  ;  but  the 
word  '  pathological '  conveys  another  meaning,  which  I  cannot  think 
suits  this  phenomenon  ;  at  least,  as  I  have  had  occasion  to  observe  it  in 
very  many  cases.     I  will  allow,  a  priori,  that,  among  urnings,  a  far 


UNNATURAL  ABUSE — SODOMY.  411 

higher  proportion  of  cases  of  insanit}-,  of  nervous  exhaustion,  etc.,  may 
be  observed  than  in  other  normal  men.  Does  this  increased  nervousness 
necessarily  depend  upon  the  character  of  urningism,  or  is  it  not,  in  the 
majority  of  cases,  to  be  ascribed  to  the  effect  of  the  laws  and  the  preju- 
dices of  society,  which  prohibit  the  indulgence  of  their  sexual  desires, 
depending  on  a  congenital  peculiarity,  while  others  are  not  thus 
restrained  ? 

"  The  youthful  tuning,  when  he  feels  the  first  sexual  promptings 
and  naively  expresses  them  to  his  comrades,  soon  finds  that  he  is  not 
understood ;  he  shrinks  into  himself.  If  he  tell  his  parents  or  teacher 
what  moves  him,  that  which  is  as  natural  to  him  as  swimming  is  to  a 
fish  is  described  as  wrong  and  sinful,  and  he  is  told  it  must  be  fought 
and  overcome  at  any  price.  Then  an  inner  conflict  begins,  a  powerful 
repression  of  sexual  inclinations ;  and  the  more  the  natural  satisfaction 
of  desire  is  repressed,  the  more  lively  the  fancy  becomes,  and  paints  the 
very  pictures  that  the  wish  is  to  banish.  The  more  energetic  the  charac- 
ter that  carries  on  this  inner  conflict,  the  more  the  whole  nervous  system 
must  suffer.  Such  a  powerful  repression  of  an  instinct  so  deeply 
implanted  in  us,  in  my  opinion,  develops  the  abnormal  symptoms  which 
are  observed  in  many  urnings ;  but  this  does  not  necessarily  follow  from 
the  urning's  disposition. 

"  Some  continue  the  conflict  for  a  longer  or  shorter  time,  and  thus 
injure  themselves;  others  at  last  come  to  the  knowledge  that  the  power- 
ful instinct  born  in  them  cannot  possibly  be  sinful,  and,  therefore,  they 
cease  to  try  to  do  the  impossible, — the  repression  of  the  instinct.  Then, 
however,  begin  constant  suffering  and  excitement.  When  a  normal  man 
seeks  satisfaction  of  sexual  inclination,  he  knows  how  to  find  it  easily ;  it 
is  not  so  with  the  urning.  He  sees  men  that  attract  him,  but  he  dares 
not  say — nay,  not  even  betray  by  a  look — what  his  feelings  are.  He 
thinks  that  he  alone  of  all  the  world  has  such  abnormal  feelings.  Natu- 
rally he  seeks  the  society  of  young  men  ;  but  he  does  not  venture  to  confide 
in  them.  Thus  he  comes  to  provide  himself  with  a  satisfaction  that  he 
cannot  otherwise  obtain.  Onanism  is  practiced  inordinately,  and  fol- 
lowed by  all  the  evil  results  of  that  vice.  When,  after  a  time,  the  nerv- 
ous system  has  been  injured,  the  abnormality  is  again  not  the  result  of 
urningism,  but  it  is  produced  by  the  onanism  to  which  the  urning 
resorts,  as  a  result  of  the  public  sentiment  that  denies  him  opportunity 
to  satisfy  the  sexual  instinct  that  is  natural  to  him. 

"  Or,  let  us  suppose  the  urning  has  had  the  rare  fortune  to  soon 
find  a  person  like  himself;  or,  that  he  has  been  introduced  by  an  experi- 
enced friend  to  the  events  of  the  world  of  urnings.  Then  he  is  spared 
much  of  the  inner  conflict ;  but,  at  the  same  time,  fearful  cares  and 
anxieties  follow  his  footsteps.  Now  he  knows  that  he  is  not  the  only 
one  in  the  world  that  has  such  abnormal  feelings ;  he  opens  his  eyes  and 
wonders  that  he  meets  so  many  of  his  kind  in  all  social  circles  and  in  all 


412  PSYCHOPATH!  A   SEXUALIS. 

callings ;  he  also  learns  that,  in  the  world  of  urnings,  as  in  the  other, 
there  is  prostitution,  and  that  men  as  well  as  women  can  be  bought. 
Thus  there  is  no  longer  any  want  of  opportunity  for  sexual  satisfaction. 
But  here  how  differently  the  experience  is  gained  from  that  obtained  in 
the  normal  manner  of  sexual  indulgence  ! 

"  Let  us  consider  the  happiest  case.  After  longing  all  one's  life, 
the  friend  of  like  feeling  is  found.  But  he  cannot  be  approached  openly, 
as  a  lover  approaches  the  girl  he  loves.  In  constant  fear,  both  must  con- 
ceal their  relations ;  nay,  even  intimacy  that  might  easily  excite  sus- 
picion— especially  should  they  not  be  of  like  age,  or  should  they  belong 
to  different  classes — must  be  kept  from  the  world.  Thus,  even  in  this 
relation,  is  forged  a  chain  of  anxiety  and  fear  that  the  secret  will  be 
betrayed  or  discovered,  which  leaves  them  no  joy  in  the  indulgence.  The 
slightest  thing  that  would  not  affect  others  makes  them  tremble  with 
fear  that  suspicion  might  be  excited  and  the  secret  discovered,  and 
destroy  social  position  and  business.  Could  this  constant  anxiety  and 
care  be  endured  without  leaving  a  trace,  without  exerting  an  influence 
on  the  entire  nervous  system  ? 

"  Another  less  fortunate  man  does  not  find  a  friend  of  like  feeling, 
but  falls  into  the  hands  of  a  handsome  man,  who  sought  him  until  the 
secret  was  discovered.  Now  the  most  refined  blackmail  is  extorted.  The 
unfortunate,  persecuted  man,  brought  to  the  alternative  of  paying  or  of 
losing  his  social  position,  and  bringing  disgrace  on  himself  and  his  family, 
pays ;  and  the  more  he  gives,  the  more  voracious  the  vampire  becomes ; 
until  at  last  there  remains  nothing  but  absolute  financial  ruin  or  dishonor. 
Who  can  wonder  that  nerves  are  not  equal  to  such  a  terrible  struggle ! 

"  They  give  way ;  insanity  comes  on ;  and  the  miserable  man  at  last 
finds  the  rest  in  an  asylum  that  he  could  not  find  in  the  world.  Another, 
in  the  same  situation,  driven  to  despair,  finds  relief  in  suicide.  It  cannot 
be  known  how  many  of  the  suicides  of  young  men  are  to  be  attributed 
to  this  combination  of  circumstances. 

"  I  do  not  think  that  I  am  in  error  when  I  declare  that  at  least  one- 
half  of  the  suicides  of  young  men  are  due  to  such  conditions.  Even 
in  those  cases  where  urnings  are  not  persecuted  by  a  heartless  villain, 
but  where  a  happy  relation  between  two  men  exists,  discovery,  or  even 
the  fear  of  it,  very  often  leads  to  suicide.  How  many  officers,  how  many 
soldiers,  having  such  relations  with  their  subordinates  or  companions,  in 
the  moment  when  they  have  believed  themselves  discovered,  have  sought 
to  escape  the  threatened  disgrace  by  means  of  a  bullet  I  And  it  is  the 
same  in  all  callings. 

"  Therefore,  if  it  must  be  admitted  that,  among  urnings,  more 
mental  abnormalities  and  more  insanity  are  actually  observed  than  among 
other  men,  yet  this  does  not  prove  that  the  mental  disturbance  is  a 
necessary  accompaniment  of  the  urning's  condition,  and  that  the  latter 
induces  the  former. 


UNNATURAL   ABUSE — SODOMY.  413 

"  According  to  my  firm  conviction,  by  far  the  greater  number  of 
cases  of  mental  disturbance  or  abnormal  disposition  observed  in  urnings 
are  not  to  be  attributed  to  the  sexual  anomaly ;  but  they  are  caused  by 
the  existing  notions  concerning  urnings,  and  the  resulting  laws,  and 
dominant  public  sentiment  concerning  the  anomaly.  Any  one  with  an 
adequate  idea  of  the  mental  and  moral  suffering,  of  the  anxiety  and  care, 
that  the  uming  must  endure ;  of  the  constant  hypocrisy  and  secrecy 
he  must  practice,  in  order  to  conceal  his  inner  instinct ;  of  the  difficulties 
that  meet  him  in  satisfying  his  natural  desire, — can  only  be  surprised 
that  more  insanity  and  nervous  disturbance  does  not  occur  in  urnings. 
The  greater  part  of  these  abnormal  states  would  not  be  developed,  if  the 
urning,  like  another,  could  find  a  simple  and  easy  way  in  which  to  satisfy 
his  sexual  desire, — if  he  were  not  forever  troubled  by  these  anxieties ! " 

De  lege  lata,  as  far  as  the  urning  is  concerned,  the  para- 
graph with  reference  to  pederasty  must  not  be  applied  without 
the  proof  of  actual  pederasty ;  and  psychical  and  somatic  abnor- 
malities must  be  examined  by  experts  with  respect  of  an  esti- 
mate in  the  individual  of  the  question  of  guilt. 

De  lege  ferenda,  the  urnings  wish  a  repeal  of  the  para- 
graphs. The  jurist  could  not  consent  to  this,  if  he  were  to 
remember  that  pederasty  is  much  more  frequently  a  disgusting 
vice  than  the  result  of  physical  and  mental  infirmity ;  and  that, 
moreover,  many  urnings,  though  driven  to  sexual  acts  with 
their  own  sex,  are  yet  in  nowise  compelled  to  indulge  in  peder- 
asty,— a  sexual  act  which,  under  all  circumstances,  must  stand 
as  cynical,  disgusting,  and,  when  passive,  as  certainly  injurious. 
Whether  for  reasons  of  expediency  (difficulty  of  fixing  the 
guilt,  encouragement  of  blackmail,  etc.),  it  would  not  be  oppor- 
tune to  strike  from  the  statutes  the  legal  punishment  of  the 
male-loving  man,  and  to  protect  youth  by  the  use  of  the  para- 
graphs concerning  sexual  abuses,  is  a  future  question  for  jurists. 

What  has  been  said  concerning  congenital  contrary  sexu- 
ality and  its  relation  to  the  law  is  also  applicable  to  the  acquired 
abnormality.  The  accompanying  neurosis  or  psychosis  should 
have  much  diagnostic  and  forensic  weight  with  reference  to  the 
question  of  guilt. 

It  only  remains  to  describe  acquired  non-pathological  ped- 
erasty,— one  of  the  saddest  pages  in  the  history  of  human 
delinquencies : — 


414  PSYCHOPATHIA   SEXUALIS. 

Cultivated  Pederasty.1 

The  motives  that  bring  to  pederasty  a  man  originally  nor- 
mal sexually  and  of  sound  mind  are  various.  It  is  used  tem- 
porarily as  a  means  of  sexual  satisfaction  faute  de  mietix,- — as 
in  infrequent  cases  of  bestiality, — where  abstinence  from  normal 
sexual  indulgence  is  a  necessity.2  It  thus  occurs  on  shipboard 
during  long  voyages,  in  prisons,  in  baths,  etc.  It  is  highly  prob- 
able that,  among  men  subjected  to  such  conditions,  there  are 
single  individuals  of  low  morals  and  great  sensuality,  or  actual 
urnings,  who  seduce  the  others.  Lust,  imitation,  and  desire 
further  their  purpose. 

The  strength  of  the  sexual  instinct  is  most  markedly  showu 
by  the  fact  that  such  circumstances  are  sufficient  to  overcome 
repugnance  for  the  unnatural  act. 

Another  category  of  pederasts  is  made  up  of  old  roues 
that  have  become  supersatiated  in  normal  sexual  indulgence, 
and  who  find  in  pederasty  a  means  of  exciting  sensual  pleasure, 
the  act  being  a  new  method  of  stimulation.  Thus  they  tem- 
porarily renew  their  power,  that  has  been  psychically  and  phys- 
ically reduced  to  so  low  a  state.  The  new  sexual  situation 
makes  them,  so  to  speak,  relatively  potent,  and  makes  pleasure 
possible  that  is  no  longer  possible  in  normal  intercourse.  In 
time  power  to  indulge  in  pederasty  is  also  lost.  The  individual 
may  thus  finally  be  reduced  to  passive  pederasty  as  a  stimulus 
to  make  possible  temporary  active  pederasty ;  just  as,  occasion- 
ally, flagellation  or  looking  on  at  obscene  acts  (Maschka's  case 
of  mutilation  of  animals)  is  resorted  to  for  the  same  purpose. 

The  termination  of  sexual  activity  expresses  itself  in  all  kinds 
of  abuse  of  children, — cunnilingus,  fellare,  and  other  enormities. 

This  kind  of  pederasts  is  the  most  dangerous,  since  they 
deal  mostly  with  boys,  and  ruin  them  in  body  and  soul. 

1  For  interesting  histories  and  notes,  v.  Krause,  Psychol,  des  Verbrechens,  p.  174. — 
Tardieu,  Attentats. — Maschka,  Handb.,  iii,  p.  174.  This  vice  seems  to  have  come  through 
Crete  from  Asia  to  Greece,  and,  in  the  times  of  classic  Hellas,  to  have  been  wide-spread. 
From  there  it  spread  to  Rome,  where  it  nourished  luxuriantly.  In  Persia  and  China 
(where  it  is  actually  tolerated)  it  is  wide-spread,  as  it  also  is  in  Europe.  (Comp.  Tar- 
nowsky  et  al. ) 

2  Lombroso  (Der  Verbrecher,  p.  20  et  scq.)  shows  that  also,  in  case  of  animals, 
intercourse  with  the  same  sex  occurs  where  normal  indulgence  is  impossible. 


CULTIVATED   PEDERASTY.  415 

In  reference  to  this,  the  experiences  of  Tarnowsky  (op.  cit.,  p.  53 
et  seq.),  gathered  from  the  society  of  St.  Petersburg,  are  terrible.  The 
places  where  pederasty  is  cultivated  are  Institutes.  Old  roues  and  tim- 
ings play  the  role  of  seducers.  At  first  it  is  difficult  for  the  person  to 
carry  out  the  disgusting  act.  Fancy  is  made  to  assist  by  calling  up 
the  image  of  a  woman.  Gradually,  with  practice,  the  unnatural  act  be- 
comes easy,  and  at  last  the  individual,  like  one  injured  by  masturbation, 
becomes  relatively  impotent  for  women,  and  lustful  enough  to  find  pleas- 
ure in  the  perverse  act.  Such  individuals,  under  certain  circumstances, 
give  themselves  for  money. 

As  Tardieu,  Hofmann,  Simon,  and  Taylor  show,  such  individuals 
are  not  infrequently  found  in  large  cities.  From  numerous  statements 
made  to  me  by  urnings,  it  is  learned  that  actual  prostitution  and  houses 
of  prostitution  for  male-loving  men  exist  in  large  cities.  The  arts  of 
coquetry  used  by  these  male  prostitutes  are  noteworthy, — ornament, 
perfumes,  feminine  styles  of  dress,  etc.,  to  attract  pederasts  and  urnings. 
This  imitation  of  feminine  peculiarities  is  spontaneous  and  unconscious 
in  congenital  cases,  and  in  many  acquired  cases  of  (abnormal)  contrary 
sexual  instinct. 

The  following  lines  are  of  interest  to  the  psychologist,  and 
offer  the  officers  of  the  law  important  facts  concerning  the 
social  life  and  practice  of  pederasts : — 

Coffignon,  "  La  Corruption  a  Paris,"  p.  327,  divides  active  peder- 
asts into  "  amateurs"  "  entreteneurs"  and  "  souteneurs." 

The  "  amateurs  "  ("  rivettes  ")  are  debauched  persons,  but  also  fre- 
quently congenitally  perverse  sexually,  of  position  and  fortune,  who  are 
forced  to  guard  themselves  against  detection  in  the  gratification  of  their 
homo-sexual  desires.  For  this  purpose  they  visit  brothels,  lodging- 
houses,  or  the  private  houses  of  female  prostitutes,  who  are  usually  on 
good  terms  with  male  prostitutes.     Thus  they  escape  blackmail. 

Some  of  these  "  amateurs  "  are  cunning  enough  to  indulge  their  vile 
desires  in  public  places.  They  thus  run  the  risk  of  arrest,  but,  in  a 
large  city,  little  risk  of  blackmail.  Danger  is  said  to  add  to  their  secret 
pleasure. 

The  "  entreteneurs"  are  old  sinners  who,  even  with  the  danger  of 
falling  into  the  hands  of  blackmailers,  cannot  deny  themselves  the 
pleasure  of  keeping  a  (male)  mistress. 

The  "  souteneurs  "  are  pederasts  that  have  been  punished,  who  keep 
their  "jesus"  whom  they  send  out  to  entice  customers  ("/aire  chanter 
les  rivettes  "),  and  who  then,  at  the  right  moment,  if  possible,  appear  for 
the  purpose  of  plucking  the  victim. 

Not  infrequently  they  live  together  in  bands,  the  members,  in 
accordance  with  individual  desire,  living  together  as  husbands  and  wives, 


416  PSTCHOPATHIA   SEXUALIS. 

In  such  bands  there  are  formal  marriages,  betrothals,  banquets,  and 
introductions  of  brides  and  grooms  into  their  apartments. 

These  "  souteneurs"  attach  their  u jesus  "  to  themselves. 

The  passive  pederasts  are  "  petits  jusus"  u  jesus"  or  "  aunts." 

The  "  petits  jesus  "  are  lost,  depraved  children,  whom  accident  places 
in  the  hands  of  active  pederasts,  who  seduce  them,  and  reveal  to  them 
the  horrible  means  of  earning  a  livelihood,  either  as  "  entretenus  "  or  as 
male  street-walkers,  with  or  without  "  souteneurs." 

The  most  suitable  and  promising  "  petits  jesus  "  are  given  into  the 
hands  of  persons  who  instruct  these  children  in  the  art  of  female  dress 
and  manner.  Gradually  they  then  seek  to  emancipate  themselves  from 
their  teachers  and  masters,  in  order  to  become  "femmes  entretenues" ; 
and  not  infrequently  by  means  of  anonymous  denunciation  of  their 
"  souteneurs  "  to  the  police. 

It  is  the  object  of  the  "  souteneur  "  and  the  " petit  jesus  "  to  make 
the  latter  appear  young,  as  long  as  possible,  by  means  of  all  the  arts  of 
the  toilet. 

The  limit  of  age  is  about  twenty -five  years ;  then  they  all  become 
" jesus"  and  " femmes  entretenues"  and  are  then  sustained  by  several 
"  souteneurs."  The  "  jesus  "  fall  into  three  categories  :  "  Jilles  gallatites" 
i.e.,  those  that  have  fallen  again  into  the  hands  of  a  "  souteneur " ; 
"  pierreuses  "  (ordinary  street-walkers,  like  their  female  colleagues)  ;  and 
"  domestics." 

The  "  domestics  "  hire  out  to  active  pederasts,  either  to  gratify  their 
desires  or  to  obtain  "  petits  jesus  "  for  them. 

A  sub-group  of  these  "  domestics  "  is  formed  by  such  of  them  as 
enter  the  service  of  tl petits  jesus"  as  " femmes  de  chambre."  The 
principal  object  of  these  "  domestics  "  is* to  use  their  positions  to  obtain 
compromising  knowledge,  with  which  they  later  practice  blackmail,  and 
thus  assure  themselves  ease  in  their  old  age. 

The  most  horrible  class  of  active  pederasts  is  made  up  of  the 
"  aunts" — i.e.,  the  "  souteneurs  "  of  (male)  prostitutes, — who,  though 
normal  sexually,  are  morally  depraved,  and  practice  pederasty  (passive) 
only  for  gain,  or  for  the  purpose  of  blackmail. 

The  wealthy  "  amateurs  "  have  their  reunions  and  places  of  meeting, 
where  the  passive  ones  appear  in  female  attire,  and  horrible  orgies  take 
place.  The  waiters,  musicians,  etc.,  at  such  gatherings,  are  all  pederasts. 
The  "jilles  gallantes  "  do  not  venture,  except  during  the  carnival,  to  show 
themselves  on  the  street  in  female  dress ;  but  they  know  how  to  lend  to 
their  appearance  something  indicative  of  their  calling,  by  means  of  style 
of  dress,  etc.  They  entice  b}7  means  of  gesture,  peculiar  movements  of 
the  hands,  etc.,  and  lead  their  victims  to  hotels,  baths,  or  brothels. 

What  the  author  says  of  blackmail  is  generally  known.  There 
are  cases  where  pederasts  have  allowed  their  entire  fortune  to  be  wrung 
from  them. 


CULTIVATED   PEDERASTY.  417 

The  following  notice  from  a  Berlin  (National  1)  newspaper, 
of  February,  1884,  which  fell  into  my  hands  by  accident,  seems 
suited  to  show  something  of  the  life  and  customs  of  urnings : — 

"  The  Woman- Haters1  Ball. — Almost  every  social  element  of  Berlin 
has  its  social  reunions, — the  fat,'the  bald-headed,  the  young, — and  why  not 
the  woman-haters  ?  This  species  of  men,  so  interesting  psychologically 
and  none  too  edifying,  had  a  great  ball  to-day.  '  Grand  Vienna  Mask-Ball,' 
— so  ran  the  notice.  The  sale  of  tickets  was  very  rigorous ;  they  wish  to 
be  very  exclusive.  Their  rendezvous  was  a  well-known  dance-hall.  We 
enter  the  hall  about  midnight.  The  graceful  dancing  is  to  the  strains  of 
a  fine  orchestra.  Thick  tobacco-smoke,  veiling  the  gas-lights,  does  not 
allow  the  details  of  the  moving  mass  to  become  obvious ;  only  during 
the  pause  between  the  dances  can  we  obtain  a  closer  view.  The  masks 
are  by  far  in  the  majority ;  black  dress-coats  and  ball-gowns  are  seen  only 
now  and  then. 

"  But  what  is  that  ?  The  lady  in  rose-tarletan,  that  just  now  passed 
us,  has  a  lighted  cigar  in  the  corner  of  her  mouth,  and  puffs  like  a 
trooper ;  and  she  also  wears  a  small,  blonde  beard,  lightly  painted  out. 
And  yet  she  is  talking  with  a  very  decollete  '  angel '  in  tricots,  who 
stands  there,  with  bare  arms  folded  behind  her,  likewise  smoking.  The 
two  voices  are  masculine,  and  the  conversation  is  likewise  very  mascu- 
line ;  it  is  about  the  '  d —  tobacco,  that  permits  no  air.'  Two  men  in 
female  attire.  A  conventional  clown  stands  there,  against  a  pillar,  in 
soft  conversation  with  a  ballet-dancer,  with  his  arm  around  her  faultless 
waist.  She  has  a  blonde  '  Titus-head,'  sharp-cut  profile,  and  apparently  a 
voluptuous  form.  The  brilliant  ear-rings,  the  necklace  with  a  medallion, 
the  full,  round  shoulders  and  arms,  do  not  permit  a  doubt  of  her  '  genu- 
ineness,' until,  with  a  sudden  movement,  she  disengages  herself  from  the 
embracing  arm,  and,  yawning,  moves  away,  saying,  in  a  deep  bass, 
'  Emile,  you  are  too  tiresome  to-day ! '     The  ballet-dancer  is  also  a  male  I 

"  Suspicious  now,  we  look  about  further.  We  almost  suspect  that 
here  the  world  is  topsy-turvy ;  for  here  goes,  or,  rather,  trips,  a  man — 
no,  no  man  at  all,  even  though  he  wears  a  carefully  trained  moustache. 
The  well-curled  hair ;  the  powdered  and  painted  face  with  the  blackened 
eyebrows ;  the  golden  ear-rings ;  the  bouquet  of  flowers  reaching  from 
the  left  shoulder  to  the  breast,  ornamenting  the  elegant  black  gown ;  the 
golden  bracelets  on  the  wrists ;  the  elegant  fan  in  the  white-gloved  hand, 
— all  these  things  are  anything  but  masculine.  And  how  he  toys  with 
the  fan !  How  he  dances  and  turns,  and  trips  and  lisps !  And  yet 
kindly  Nature  made  this  doll  a  man.  He  is  a  salesman  in  a  great  milli- 
nery store,  and  the  ballet-dancer  mentioned  is  his  'colleague.' 

"  At  a  little  corner-table  there  seems  to  be  a  great  social  circle. 
Several  elderly  gentlemen  press  around  a  group  of  decollete  ladies,  who 

27 


418  PSYCHOPATHIA    SEXUALIS. 

sit  over  a  glass  of  wine  and — in  the  spirit  of  fun — make  jokes  that  are  none 
too  delicate.  "Who  are  these  three  ladies  ?  '  Ladies  ! '  laughs  my  knowing 
friend.  '  Well,  the  one  on  the  right,  with  the  brown  hair  and  the  short, 
fancy  dress,  is  called  "  Butterrieke,"  and  he  is  a  hair-dresser ;  the  second 
one — the  blonde  in  a  singer's  costume,  with  the  necklace  of  pearls — is 
known  here  by  the  name  of  "  Miss  Ella  of  the  tight-rope,"  and  he  is  a 
ladies'  tailor;  and  the  third, — that  is  the  widely -celebrated  "  Lottie."' 

"  But  that  person  cannot  possibly  be  a  man  ?  That  waist,  that 
bust,  those  classic  arms,  the  whole  air  and  person  are  markedly  feminine ! 

"  I  am  told  that '  Lottie '  was  once  a  book-keeper.  To-day  she,  or, 
rather,  he,  is  exclusively  '  Lottie,'  and  takes  pleasure  in  deceiving  men 
about  his  sex  as  long  as  possible.  '  Lottie '  is  singing  a  song  that  would 
hardly  do  for  a  drawing-room,  in  a  high  voice,  acquired  by  years  of  prac- 
tice, which  many  a  soprano  might  envy.  '  Lottie  '  has  also  '  worked '  as  a 
female  comedian.  Now  the  quondam  book-keeper  has  so  entered  into  the 
female  role  that  he  appears  on  the  street  in  female  attire  almost  exclu- 
sively, and,  as  the  people  with  whom  he  lodges  state,  uses  an  embroidered 
night-dress. 

"  On  closer  examination  of  the  assembly,  to  my  astonishment,  I 
discover  acquaintances  on  all  hands :  my  shoe-maker,  whom  I  should 
have  taken  for  anything  but  a  woman-hater — he  is  a  '  troubadour,'  with 
sword  and  plume ;  and  his  '  Leonora,'  in  the  costume  of  a  bride,  is  accus- 
tomed to  place  my  favorite  brand  of  cigars  before  me  in  a  certain  cigar- 
store.  '  Leonora,'  who,  during  an  intermission,  removes  her  gloves,  I 
recognize  with  certainty  by  her  large,  blue  hands.  Right !  There  is  my 
haberdasher,  also ;  he  moves  about  in  a  questionable  costume  as  Bac- 
chus, and  is  the  swain  of  a  repugnantly  bedecked  Diana,  who  works  as 
a  waiter  in  a  beer-restaurant.  The  real  '  ladies '  of  the  ball  cannot  be 
described  here.  They  associate  only  with  one  another,  and  avoid  the 
woman-hating  men  ;  and  the  latter  are  exclusive,  and  amuse  themselves, 
absolutely  ignoring  the  charms  of  the  women." 

These  facts  deserve  the  careful  attention  of  the  police,  who 
should  be  placed  in  a  position  to  cope  with  male  prostitution,  as 
they  now  do  with  that  of  women. 

Male  prostitution  is  certainly  much  more  dangerous  to 
society  than  that  of  females;  it  is  the  darkest  stain  on  the 
history  of  humanity. 

From  the  statements  of  a  high  police  official  of  Berlin,  I 
learn  that  the  police  of  Berlin  are  conversant  with  the  male 
demi-monde  of  the  German  Capital,  and  do  all  they  can  to  sup- 
press blackmail  among  pederasts, — a  practice  which  often  does 
not  stop  short  of  murder. 


CULTIVATED   PEDERASTY.  419 

The  foregoing  facts  justify  the  wish  that  the  law-maker  of 
the  future  may,  for  reasons  of  utility,  at  least,  abandon  the 
prosecution  of  pederasty. 

With  reference  to  this  point,  it  is  worthy  of  note  that  the 
French  Code  does  not  punish  it  so  long  as  it  does  not  become 
an  offense  to  public  decency.  Probably  for  politico-legal 
reasons,  the  new  Italian  Penal  Code  passes  over  the  crime  of 
unnatural  abuse  in  silence,  as  do  the  statutes  of  Holland  and, 
as  far  as  I  know,  Belgium  and  Spain. 

In  how  far  such  cultivated  pederasts  are  to  be  regarded  as 
mentally  and  morally  sound  may  remain  an  open  question. 
The  majority  of  them  suffer  with  genital  neuroses.  At  least,  in 
these  cases,  there  are  the  stages  of  transition  to  acquired  patho- 
logical contrary  sexual  instinct.  The  responsibility  of  these 
individuals,  who  are  certainly  much  lower  than  the  women  who 
prostitute  themselves,  in  general  cannot  be  questioned. 

The  various  categories  of  male-loving  men,  with  respect  of 
the  manner  of  sexual  indulgence,  may  be  thus  characterized  in 
general : — 

The  congenital  urning  becomes  a  pederast  only  exception- 
ally, and  eventually  resorts  to  it  after  having  practiced  and 
exhausted  all  the  possible  immoral  acts  with  males.  Passive 
pederasty  is  for  him  the  ideally  and  practically  adequate  form 
of  the  sexual  act.  He  practices  active  pederasty  only  to  please 
another.  The  most  important  point  here  is  the  congenital  and 
unchangeable  perversion  of  the  sexual  instinct. 

It  is  otherwise  with  the  pederast  by  cultivation.  He  has 
once  acted  normally  sexually,  or,  at  least,  had  normal  incli- 
nations, and  occasionally  has  intercourse  with  the  opposite  sex. 
His  sexual  perversity  is  neither  congenital  nor  unchangeable. 
He  begins  with  pederasty  and  ends  in  other  perverse  sexual  acts, 
induced  by  weakness  of  the  centres  for  erection  and  ejaculation. 
At  the  height  of  his  power,  his  sexual  desire  is  not  for  passive, 
but  for  active  pederasty.  He  yields  himself  to  passive  pederasty 
only  to  please  another ;  for  money,  in  the  role  of  a  male  prosti- 
tute ;  or  as  a  means,  when  virility  is  declining,  to  make  active 
pederasty  still  occasionally  possible. 


420  PSYCHOPATHIA   SEXUALIS. 

A  horrible  act,  that  must  be  alluded  to,  in  conclusion,  is 
paBdicatio  mulierum,1  and  even  uxorum.  Sensual  individuals 
sometimes  do  it  with  hardened  prostitutes,  or  even  with  their 
wives.  Tardieu  gives  examples  where  men,  usually  practicing 
coitus,  sometimes  indulged  in  pederasty  with  their  wives.  Occa- 
sionally fear  of  a  repetition  of  pregnancy  may  induce  the  man 
to  perform,  and  the  woman  to  tolerate,  the  act. 

Case  192.  Imputation  of  pederasty  that  was  not  proved.  Resume 
from  the  legal  proceedings  : — 

On  May  30,  1888,  Dr.  S.,  chemist,  of  H.,  in  an  anonymous  letter, 
was  accused  by  his  step-father  of  having  immoral  relations  with  G.,  aged 
19,  the  son  of  a  butcher.  Dr.  S.  received  the  letter,  and,  astounded  by 
its  contents,  hastened  to  his  lawyer,  who  promised  to  proceed  discreetly 
in  the  matter,  and  to  ascertain  from  the  authorities  whether  he  would  be 
publicly  prosecuted. 

On  the  next  morning,  G.,  who  lived  in  the  house  of  Dr.  S.,  was 
arrested.  At  the  time  he  was  sick  with  gonorrhoea  and  orchitis.  Dr.  S. 
tried  to  induce  the  authorities  to  release  G.,  and  advised  caution,  but  he 
was  refused.  In  his  statement  to  the  judge,  S.  said  that  he  became 
acquainted  with  G.  on  the  street,  three  years  previously,  and  then  saw  no 
more  of  him  until  the  fall  of  1887,  when  he  met  him  in  his  father's  shop. 
After  November  G.  supplied  Dr.  S.'s  kitchen  with  meat, — coming  in  the 
evening  to  get  the  order,  and  bringing  the  meats  the  next  morning. 
Thus  S.  gradually  became  well  acquainted  with  G.,  and  came  to  have  a 
very  friendly  feeling  for  him.  When  S.  fell  ill  and  was,  for  the  most 
part,  confined  to  his  bed  until  the  middle  of  May,  1888,  G.  gave  him  so 
much  attention  that  S.  and  his  wife  were  much  attracted  to  him  on 
account  of  his  harmless,  child-like,  and  happy  disposition.  Dr.  S.  showed 
and  explained  to  him  his  collection  of  curiosities,  and  they  spent  the 
evenings  pleasantly  together,  the  wife  also  being  usually  present ;  besides, 
S.  and  G.  experimented  in  making  sausages,  jelly,  etc.  In  February, 
1888,  G.  fell  ill  with  gonorrhoea.  Dr.  S.,  being  his  friend,  and  having 
studied  medicine  for  seA^eral  terms,  took  care  of  G.,  procured  medicine 
for  him,  etc.  In  May,  G.  being  still  sick,  and,  for  several  reasons,  inclined 
to  leave  home,  S.  and  his  wife  took  him  into  their  own  home  to  care  for 
him.  S.  denied  the  truth  of  all  the  suspicions  that  had  been  raised  by 
this  relation,  and  defended  himself  by  pointing  to  his  life  of  previous 
respectabilHy,  his  education,  and  to  the  fact  that  G.,  at  the  time,  was 
suffering  with  a  disgusting,  contagious  disease,  and  that  he  himself  had  a 
painful  affection  (nephritic  calculus,  with  occasional  attacks  of  colic). 

1  Comp.  Tardieu,  Attentats,  p.  198. — Martineau,  Deutsche  Med.  Zeitung,  1882,  p.  9. 
— Virchow'e  Jahrb.,  1881,  i,  p.  533.— Coutagne,  Lyon  Medical,  Nos.  35,  36. 


CULTIVATED    PEDERASTY.  421 

Opposed  to  this  statement  of  Dr.  S.'s  must  be  mentioned  the  facts 
that  were  brought  out  in  court,  and  which  led  to  conviction  in  the  first 
trial. 

The  relation  of  S.  to  G.  had,  by  reason  of  its  obviousness,  given 
cause  for  remark  by  private  individuals,  as  well  as  by  those  in  public 
houses.  G.  spent  almost  all  his  evenings  with  S.'s  family,  and,  finally, 
came  to  be  quite  at  home  there.  They  took  walks  together.  Once,  while 
out  on  such  a  walk,  S.  said  to  G.  that  he  was  a  pretty  fellow,  and  that  he 
(S.)  was  very  fond  of  him.  On  the  same  occasion,  there  was  also  talk  of 
sexual  matters,  and  also  of  pederasty.  S.  said  he  touched  on  these  sub- 
jects only  to  warn  G.  With  reference  to  the  intercourse  at  home,  it  was 
proved  that  occasionally  S.,  while  sitting  on  a  sofa,  embraced  G.,  and 
kissed  him.  This  happened  in  the  presence  of  the  wife,  as  well  as  of  the 
servant-girls.  When  G.  was  ill  with  gonorrhoea,  S.  instructed  him  in  the 
method  of  using  a  syringe,  and,  at  the  time,  took  the  penis  in  his  hand. 
G.  testified  that  S.,  in  answer  to  his  question  why  he  was  so  fond  of  him, 
said, "  I  don't  know,  myself."  When,  one  day,  G.  remained  away,  S.,  with 
tears  in  his  eyes,  complained  of  it  to  him  when  he  returned.  S.  also  told 
him  that  his  marriage  was  unhappy,  and,  in  tears,  begged  G.  not  to  leave 
him ;  that  he  must  take  the  place  of  his  wife. 

From  all  this  resulted  the  just  accusation,  that  the  relation  between 
the  culprits  had  a  sexual  direction.  The  fact  that  all  was  open  and 
known  to  eArerybody,  according  to  the  complaint,  did  not  speak  for  the 
harmlessness  of  the  relation,  but  more  for  the  intensity  of  the  passion  of 
S.  The  spotless  life  of  the  accused  was  allowed,  as  well  as  his  honesty 
and  gentleness.  The  probability  of  an  unhappy  marriage,  and  that  S.  was 
of  a  very  sensual  nature,  was  shown. 

During  the  course  of  the  trial,  G.  was  repeatedly  examined  by  the 
medical  experts.  He  is  scarcely  of  medium  size,  pale,  and  of  powerful 
frame ;  penis  and  testicles  are  very  perfectly  developed  (large). 

In  consonance  with  the  accusation,  it  was  found  that  the  anus  was 
pathologically  changed,  in  that  there  were  no  wrinkles  in  the  skin  about 
it  and  the  sphincter  was  relaxed ;  and  it  was  presumed  that  these  changes 
pointed  to  the  probability  of  passive  pederasty. 

The  conviction  was  based  on  these  facts.  The  judgment  passed 
recognized  that  the  relation  that  existed  between  the  culprits  did  not 
necessarily  point  to  unnatural  abuses,  any  more  than  did  the  physical 
conditions  found  on  the  person  of  G. 

However,  by  reason  of  the  combination  of  the  two  facts,  the  court 
was  convinced  of  the  guilt  of  both  culprits,  and  held  it  proved  :  "  That 
the  abnormal  condition  of  G.'s  anus  had  been  caused  by  the  frequently 
repeated  introduction  of  the  penis  of  S.,  and  that  G.  voluntarily  permitted 
the  performance  of  this  immoral  act  on  himself." 

Thus  the  conditions  of  §  175,  R.  St.  G.  B.,  seemed  to  be  covered. 
In  passing  sentence,  there  was  consideration  of  S.'s  education,  which 


422  PSYCHOPATHIA   SEXUALIS. 

made  him  appear  to  be  G.'s  seducer ;  in  G.'s  case,  this  fact  and  his  youth 
were  given  weight ;  and  the  previous  respectability  of  both  was  held  in 
view.  Thus  Dr.  S.  was  sentenced  to  imprisonment  for  eight  months,  and 
G.  for  four  months. 

The  culprits  appealed  to  the  Supreme  Court  at  Leipzig,  and  prepared 
themselves,  in  case  the  appeal  should  be  denied,  to  collect  evidence 
sufficient  to  call  for  a  new  trial. 

They  subjected  themselves  to  examination  and  observation  by  dis- 
tinguished experts.  The  latter  declared  that  G.'s  anus  presented  no 
signs  of  indulgence  in  passive  pederasty. 

Since  it  seemed  of  importance  to  those  interested  to  make  clear  the 
psychological  aspect  of  the  case,  which  was  not  touched  on  at  the  trial, 
the  author  was  intrusted  with  the  examination  and  observation  of  Dr.  S. 
and  G. 

Results  of  the  Personal  Examination,  from  December  11  to  13, 1888, 
in  Graz. — Dr.  S.,  aged  37 ;  two  years  married,  without  children.  Ex- 
Director  of  the  City  Laboratory  of  H.  He  comes  of  a  father  who  is 
said  to  have  been  nervous,  owing  to  great  activity ;  who  had  an  apoplec- 
tic attack  in  his  fifty-seventh  year,  and  died,  at  the  age  of  sixty-seven,  of 
another  attack  of  apoplexy.  His  mother  is  living,  and  is  described  as  a 
strong  person,  who  has  been  nervous  for  }^ears.  Her  mother  reached 
quite  an  old  age,  and  is  said  to  have  died  of  a  cerebellar  tumor.  A 
brother  of  the  mother's  father  is  said  to  have  been  a  drinker.  The 
paternal  grandfather  died  early,  of  softening  of  the  brain. 

Dr.  S.  has  two  brothers,  who  are  in  perfect  health. 

He  states  that  he  is  of  nervous  temperament,  and  has  been  of  strong 
constitution.  After  articular  rheumatism,  which  he  had  in  his  fourteenth 
year,  he  suffered  with  great  nervousness  for  some  months.  Thereafter  he 
often  suffered  with  rheumatic  pains,  palpitation,  and  shortness  of  breath. 
These  symptoms  gradually  disappeared  with  sea-bathing.  Seven  years 
ago  he  had  gonorrhoea.  »  This  disease  became  chronic,  and  for  a  long  time 
caused  bladder-difficulty. 

In  1887  he  had  his  first  attack  of  renal  colic,  and  he  had  such 
attacks  repeatedly  during  the  winter  of  1887  and  1888,  until  May  16, 
1888,  when  quite  a  large  renal  calculus  was  passed.  Since  then  his  con- 
dition had  been  quite  satisfactory.  While  suffering  with  stone,  during 
coitus,  at  the  moment  of  ejaculation,  he  felt  severe  pain  in  the  urethra, 
and  the  same  pain  on  urinating. 

With  reference  to  his  life,  S.  states  that  he  attended  the  Gymnasium 
until  he  was  fourteen,  but  after  that,  owing  to  the  results  of  his  severe 
illness,  he  studied  privately.  He  then  spent  four  years  in  a  drug-store, 
and  then  studied  medicine  for  six  semesters  at  the  University,  serving,  in 
the  war  of  1870,  as  a  voluntary  hospital  assistant.  Since  he  had  no  cer- 
tificate of  graduation  from  the  Gymnasium,  he  gave  up  the  stud}'  of 
medicine,  and  obtained  the  degree  of  doctor  of  philosophy.     Then  he 


CULTIVATED   PEDERASTY.  423 

served  in  the  Museum  of  Minerals  in  K.,  and  later  as  assistant  in  the 
Mineralogical  Institute  of  H.  Thereafter  he  made  special  studies  in 
the  chemistry  of  food-stuffs,  and  five  years  ago  became  Director  of  the 
City  Laboratory. 

He  makes  all  these  statements  in  a  prompt,  precise  manner,  and 
does  not  think  long  about  his  answers  ;  so  that  one  is  more  and  more  led 
to  think  that  he  is  a  man  who  loves  and  speaks  the  truth, — the  more, 
since,  on  the  following  day,  his  statements  are  identical.  With  reference 
to  his  vita  sexualis,  Dr.  S.,  in  a  modest,  delicate,  and  open  way,  states 
that,  in  his  eleventh  year,  he  began  to  have  a  knowledge  of  the  difference 
of  the  sexes,  and  for  some  time,  until  his  fourteenth  year,  was  given  to 
onanism.  He  first  had  coitus  at  eighteen,  and  thereafter  indulged  mod- 
erately. His  sensual  desire  had  never  been  very  great,  but,  until  lately, 
the  sexual  act  had  been  normal  in  every  way,  and  accompanied  by  grati- 
fying pleasurable  feeling  and  full  virility.  Since  his  marriage,  two  years 
ago,  he  had  cohabited  with  his  wife  exclusively.  He  had  married  his 
wife  out  of  love,  and  still  loved  her,  having  coitus  with  her  at  least 
several  times  a  week.  The  wife,  who  was  also  at  hand,  confirmed  these 
statements. 

All  cross-questioning  with  reference  to  a  perversion  of  sexual  feel- 
ing toward  men  Dr.  S.  answered  repeatedly  in  the  negative,  to  repeated 
examination,  and  that  without  contradiction  or  any  thought  of  the 
answers.  Even  when,  in  order  to  trap  him,  he  is  told  that  the  proof  of 
a  perverse  sexual  instinct  would  be  of  avail  in  the  trial,  he  sticks  to  his 
statements.  One  gains  the  important  impression  that  S.  has  not  the 
slightest  knowledge  of  the  facts  of  male-love.  Thus  it  is  learned  that 
his  lascivious  dreams  have  never  been  about  men ;  that  he  is  interested 
only  in  female  nudity ;  that  he  liked  to  dance  with  ladies,  etc.  No  traces 
of  any  kind  of  sexual  inclination  for  his  own  sex  can  be  discovered  in  S. 
With  reference  to  his  relations  with  G.,  Dr.  S.  expresses  himself  exactly 
as  he  did  at  his  examination  before  the  court.  In  explanation  of  his 
partiality  for  G.,  he  can  only  say  that  he  is  nervous,  and  a  man  of  feeling 
and  great  sensibilnYy,  and  very  sensitive  to  friendliness.  During  his 
illness  he  had  felt  very  lonesome  and  depressed ;  his  wife  had  frequently 
been  with  her  parents ;  and  thus  it  had  happened  that  he  had  become 
friendly  with  G.,  who  was  so  gentle  and  kind.  He  still  had  a  weakness 
for  him,  and  felt  remarkably  quiet  and  contented  while  in  his  society. 

He  had  had  two  such  close  friendships  previously  :  when  he  was 
yet  a  student,  with  a  corps-brother,- a  Dr.  A.  whom  he  also  embraced  and 
kissed ;  later,  with  a  Baron  M.  When  it  happened  that  he  could  not  see 
him  for  a  few  days,  he  became  depressed,  and  even  cried. 

He  also  had  a  similar  feeling  and  attachment  for  animals.  Thus 
he  had  a  poodle  that  died  a  short  time  ago,  mourned  like  a  member  of 
the  family;  and  he  had  often  kissed  the  animal.  (Ou  relating  this,  the 
tears  came  to  his  eyes.)     His  brother  confirmed  these  statements,  with 


424  PSYCHOPATHIA   SEXUALIS. 

the  remark,  with  reference  to  his  brother's  remarkable  friendship  for  A. 
and  M.,  that  in  these  instances  there  was  not  the  slightest  suspicion  of 
sexual  coloring  or  relation.  Too,  the  most  careful  and  detailed  exami- 
nation of  Dr.  S.  gave  not  the  slightest  reason  for  such  a  presumption. 

He  states  that  he  never  had  the  slightest  sensual  feeling  for  G.,  to 
say  nothing  of  erection  or  sensual  desire.  His  partiality  for  G.,  which 
bordered  on  jealousy,  S.  explained  as  due  mereljr  to  his  sentimental 
temperament  and  his  inordinate  friendship.  G.  was  still  as  dear  to  him 
as  if  he  were  his  son. 

It  is  worthy  of  note  that  S.  stated  that  when  Gr.  told  him  about  his 
love-adventures  with  girls,  it  had  hurt  him  only  because  Gf.  was  in  danger 
of  injuring  himself  and  ruining  his  health  by  dissipation.  He  had 
never  felt  hurt  himself  by  this.  If  he  knew  a  good  girl  for  Gr.  he  would 
be  glad  to  rejoice  with  him,  and  do  all  he  could  to  promote  their  marriage. 

S.  states  that  it  was  first  in  the  course  of  his  legal  examination  that 
he  saw  how  he  had  been  careless  in  his  intercourse  with  Gr.,  by  causing 
gossip.  His  openness  he  explained  as  due  to  the  innocence  of  the 
friendship. 

It  is  worthy  of  note  that  S.'s  wife  never  noticed  anything  suspicious 
in  the  intercourse  between  her  husband  and  G.,  though  the  most  simple 
wife  would  instinctively  notice  anything  of  that  nature.  Mrs.  S.  had 
also  made  no  opposition  to  receiving  G.  into  the  house.  On  this  point 
she  remarked  that  the  guest-chamber  in  which  G.  la}^  ill,  was  on  the 
second  floor,  while  the  living  apartments  were  on  the  fourth  ;  and,  further, 
that  S.  never  associated  alone  with  G.  as  long  as  he  was  in  the  house.  She 
states  that  she  is  convinced  of  her  husband's  innocence,  and  that  she 
loves  him  as  before. 

Dr.  S.  states  freely  that  formerly  he  had  often  kissed  G.,  and  talked 
with  him  about  sexual  matters.  G.  was  much  given  to  women,  and  in 
friendship  he  had  often  warned  him  about  sexual  dissipation,  particularly 
when  G.,  as  often  happened,  did  not  look  well.  He  had  once  said  that 
G.  was  a  handsome  fellow ;  it  was  in  a  perfectly  harmless  relation. 

The  kissing  of  G.  had  been  due  to  inordinate  friendship,  when  G. 
had  shown  him  some  particular  attention,  or  pleased  him  especially.  In 
the  act  he  had  never  had  any  sexual  feeling.  Too,  when  he  had  now  and 
then  dreamed  of  G.,  it  was  in  a  perfectly  harmless  way. 

It  appeared  of  great  importance  to  the  author  to  form  also  an 
opinion  of  G.'s  personality.  On  December  12th,  the  desired  opportunity 
was  given,  and  G.  was  carefully  examined. 

G.  is  a  young  man,  aged  20,  of  delicate  build,  whose  development 
corresponds  with  his  years ;  and  he  appears  to  be  neuropathic  and 
sensual.  The  genitals  are  normal  and  well  developed.  The  author 
thinks  he  may  be  permitted  to  pass  over  the  condition  of  the  anus, 
as  he  does  not  feel  called  upon  to  pass  judgment  upon  it.  With  pro- 
longed association  with  G.,  one  gets  the  impression  that  he  is  a  harm- 


CULTIVATED   PEDERASTY.  425 

less,  kind,  and  artless  man,  who  is  light-minded,  but  not  morally  depraved. 
Nothing  in  his  dress  or  manner  indicates  perverse  sexual  feeling.  There 
cannot  be  the  slightest  suspicion  that  he  is  a  male  courtesan. 

When  G.  is  introduced  in  medias  res,  he  states  that  S.  and  he,  feel- 
ing their  innocence,  had  told  the  matter  as  it  actually  was,  and  on  this 
the  whole  trial  had  been  based. 

At  first,  S.'s  friendship,  and  especially  the  kissing,  had  seemed 
remarkable,  even  to  him.'  Later  he  had  convinced  himself  that  it  was 
merely  friendship,  and  had  then  thought  no  more  about  it. 

G.  had  looked  upon  S.  as  a  father-like  friend ;  for  he  was  so 
unselfish,  and  loved  him  so. 

The  expression  "  handsome  fellow  "  was  made  when  G.  had  a  love- 
affair,  and  when  S.  expressed  his  fears  about  a  happy,  future  for  G.  At 
that  time  S.  had  comforted  him,  and  said  that  his  (G.'s)  appearance  was 
pleasing,  and  that  he  would  make  an  eligible  match. 

Once  S.  had  complained  to  him  (G.)  that  his  wife  was  inclined  to 
drink,  and  burst  into  tears.  G.  was  touched  by  his  friend's  unhappiness. 
On  this  occasion  S.  had  kissed  him,  and  begged  for  his  friendship,  and 
asked  him  to  visit  him  frequently. 

S.  had  never  spontaneously  directed  the  conversation  to  sexual 
matters.  G.  once  asked  what  pederasty  was,  of  which  he  had  heard 
much  while  in  England  ;  and  S.  had  explained  it  to  him. 

G.  acknowledges  that  he  is  sensual.  At  the  age  of  twelve  he  had 
been  made  acquainted  with  sexual  matters  by  schoolmates.  He  had 
never  masturbated,  had  first  had  coitus  at  the  age  of  eighteen,  and  had 
since  visited  brothels  frequently.  He  had  never  felt  any  inclination  for 
his  own  sex,  and  had  never  experienced  any  sexual  excitement  when  S. 
kissed  him.  He  had  always  had  pleasure  in  coitus  normally  performed. 
His  lascivious  dreams  had  always  been  of  women.  -  With  indignation, 
and  pointing  to  his  descent  from  a  healthy  and  respectable  family,  he 
repels  the  insinuation  of  having  been  given  to  passive  pederasty. 
Until  the  gossip  about  them  came  to  his  ears,  he  had  been  innocent  and 
devoid  of  suspicion.  The  anal  anomalies  he  tries  to  explain  in  the  same 
way  that  he  did  at  the  trial.     Auto-masturbation  in  ano  he  denies. 

It  should  be  noted  that  Mr.  J.  S.  claims  to  be  no  less  astonished 
by  the  charge  against  his  brother  of  male-love  than  those  more  closely 
associated  with  him.  Yet  he  could  not  understand  what  attached  his 
brother  to  G. ;  and  all  the  explanations  which  S.  made  to  him  concerning 
his  relation  to  G.  were  vain. 

The  author  took  the  trouble  to  observe  Dr.  S.  and  G.,  in  a  natural  way, 
while  they  were  dining,  in  company  with  S.'s  brother  and  Mrs.  S.,  in  Graz. 
This  observation  revealed  not  the  slightest  sign  of  improper  friendship. 

The  general  impression  which  Dr.  S.  made  on  me  was  that  of  a 
nervous,  sanguine,  somewhat  overstrained  individual,  but,  at  the  same 
time,  kind,  open-hearted,  and  very  emotional. 


426  PSYCHOPATHIA    SEXtJALlS. 

Dr.  S.  is  physically  strong,  somewhat  corpulent,  with  a  symmetri- 
cal, brachycephalic  cranium.  The  genitals  are  well  developed ;  the  penis 
somewhat  bellied ;  the  prepuce  somewhat  hypertrophied. 

Opinion. — Pederasty  is,  unfortunately,  not  infrequent  among  man- 
kind to-day;  but  still,  occurring  among  the  peoples  of  Europe,  it  is  an 
unusual,  perverse,  and  even  monstrous  manner  of  sexual  gratification. 
It  presumes  a  congenital  or  acquired  perversion  of  the  sexual  instinct, 
and,  at  the  same  time,  defect  of  moral  sense  that  is  either  original  or 
acquired,  as  a  result  of  pathological  influences. 

Medico-legal  science  is  thoroughly  conversant  with  the  physical  and 
psychical  conditions  from  which  this  aberration  of  the  sexual  instinct 
arises ;  and  in  the  concrete  and  doubtful  case  it  seems  requisite  to  ascer- 
tain whether  these  *  empirical,  subjective  conditions  necessary  for  peder- 
asty are  present.  Too,  it  is  essential  to  distinguish  between  active  and 
passive  pederasty. 

Active  pederasty  occurs  : — 

I.  As  a  non-pathological  phenomenon : — 

1.  As  a  means  of  sexual  gratification,  in  case  of  great  sexual  desire, 
with  enforced  abstinence  from  natural  sexual  intercourse. 

2.  In  old  debauchees,  who  have  become  satiated  with  normal  sexual 
intercourse,  and  more  or  less  impotent,  and  also  morally  depraved  ;  and 
who  resort  to  pederasty,  in  order  to  excite  their  lust  with  this  new 
stimulus,  and  aid  their  virility,  that  has  sunk  so  low  psychically  and 
physically. 

3.  Traditionally,  among  certain  barbarous  races  that  are  devoid  of 
morality. 

II.  As  a  pathological  phenomenon : — 

1.  Upon  the  basis  of  congenital  contrary  sexual  instinct,  with 
repugnance  for  sexual  intercourse  with  women,  or  even  absolute  incapa- 
bility of  it.  But,  as  even  Casper  knew,  pederasty,  under  such  conditions, 
is  very  infrequent.  The  so-called  urning  satisfies  himself  with  a  man  by 
means  of  passive  or  mutual  onanism,  or  by  means  of  coitus-like  acts 
(e.g.,  coitus  inter  femora)  ;  and  he  resorts  to  pederasty  only  very  excep- 
tionally, as  a  result  of  intense  sexual  desire,  or  with  a  low  or  lowered 
moral  sense,  out  of  desire  to  please  another. 

2.  On  the  basis  of  acquired  contrary  sexual  instinct : — 

(a)  As  a  result  of  long  years  of  onanism,  which  finally  causes 
impotence  for  women  with  continuance  of  intense  sexual  desire. 

(6)  As  a  result  of  severe  mental  disease  (senile  dementia,  brain- 
softening  of  the  insane,  etc.),  in  which,  as  experience  teaches,  an  inversion 
of  the  sexual  instinct  may  take  place. 

Passive  pederasty  occurs  : — 

I.  As  a  non-pathological  phenomenon  : — 

1.  In  individuals  of  the  lowest  class,  who,  having  had  the  misfortune 
to  be  seduced  in  boyhood  by  debauchees,  endured  pain  and  disgust  for 


CULTIVATED   PEDERASTY.  427 

the  sake  of  money,  and  became  depraved  morally,  so  that,  in  more  mature 
years,  they  have  fallen  so  low  that  they  take  pleasure  in  being  male 
prostitutes. 

2.  Under  circumstances  analogous  to  those  of  I,  1, — as  a  remunera- 
tion to  another  for  having  allowed  active  pederasty. 

II.  As  a  pathological  phenomenon  : — 

1.  In  individuals  affected  with  contrary  sexual  instinct,  with  endur- 
ance of  pain  and  disgust,  as  a  return  to  men  for  the  bestowal  of  sexual 
favors. 

2.  In  urnings  who  feel  toward  men  like  women,  out  of  desire  and  lust. 
In  such  female-men  there  is  horror  feminae  and  absolute  incapability  for 
sexual  intercourse  with  women.     Character  and  inclinations  are  feminine. 

The  empirical  facts  that  have  been  gathered  by  legal  medicine  and 
psychiatry  are  all  included  in  this  classification.  Before  the  court  of 
medical  science,  it  would  be  necessary  to  prove  that  a  man  belonged  to 
one  of  the  above  categories  in  order  to  carry  the  conviction  that  he  was 
a  pederast. 

In  the  life  and  character  of  Dr.  S.,  one  searches  in  vain  for  signs 
which  place  him  in  one  of  the  categories  of  active  pederasts  which  science 
has  established.  He  is  neither  one  forced  to  sexual  abstinence,  nor  one 
made  impotent  for  women  by  debauchery ;  neither  is  he  congenitally 
male-loving,  nor  alienated  from  women  by  masturbation,  and  attracted  to 
men  through  continuance  of  sexual  desire ;  and,  finally,  he  is  not  sexually 
perverse  as  a  result  of  severe  mental  disease. 

In  fact,  the  general  conditions  necessary  for  the  occurrence  of 
pederasty  are  wanting  in  him, — moral  imbecility  or  moral  depravity,  on 
the  one  hand,  and  inordinate  sexual  desire,  on  the  other. 

It  is  likewise  impossible  to  classify  the  accomplice,  Gf.,  in  any  of 
the  empirical  categories  of  passive  pederasty ;  for  he  possesses  neither 
the  peculiarities  of  the  male  prostitute  nor  the  clinical  marks  of  effera- 
ination ;  and  he  has  not  the  anthropological  and  clinical  stigmata  of  the 
female-man.     He  is,  in  fact,  the  very  opposite  of  all  this. 

In  order  to  make  a  pederastic  relation  between  the  two  plausible 
medico-scientifically,  it  would  be  requisite  for  Dr.  S.  to  present  the  ante- 
cedents and  marks  of  the  active  pederasts  of  I,  2,  and  G.,  those  of  the 
passive  pederasts  of  II,  1  or  2. 

The  assumption  lying  at  the  basis  of  the  verdict  is,  from  a  psycho- 
logical stand-point,  legally  untenable. 

With  the  same  right,  every  man  might  be  considered  a  pederast.  It 
remains  to  consider  whether  the  explanations  given  by  Dr.  S.  and  Gr.  of 
their  remarkable  friendship  are  psychologically  valid. 

Psychologically  it  is  not  without  parallel  that  so  sentimental  and 
eccentric  a  man  as  S. — without  any  sexual  excitement  whatever — should 
entertain  a  transcendental  friendship.  It  suffices  to  recall  the  friendship 
of  school-girls,  the  self-sacrificing  friendship  of  sentimental  young  persons 


428  PSYCHOPATHIA    SEXUALIS. 

in  general,  and  the  partiality  which  this  sensitive  man  sometimes  showed 
even  for  domestic  animals, — where  no  one  would  think  of  sodomy.  With 
S.'s  mental  character,  extraordinary  friendship  for  the  youth  Gr.  may  be 
easily  comprehended.  The  openness  of  this  friendship  permits  the  con- 
clusion that  it  was  innocent,  much  rather  than  that  it  depended  upon 
sensual  passion. 

The  defendants  succeeded  in  obtaining  a  new  trial.  The  new  trial 
took  place  on  March  T,  1890.  There  was  much  evidence  presented  in 
favor  of  the  accused. 

The  previous  moral  life  of  S.  was  generally  acknowledged.  The 
Sister  of  Charity  who  cared  for  G.  in  S.'s  house,  never  noticed  anything 
suspicious  in  the  intercourse  between  S.  and  Gr.  S.'s  former  friends  tes- 
tified to  his  morality,  his  deep  friendship,  and  his  habit  of  kissing  them 
on  meeting  or  leaving  them.  The  anal  abnormalities  previously  found 
on  Gr.  were  no  longer  present.  Experts  called  by  the  court  allowed  the 
possibility  that  they  had  been  due  simply  to  digital  manipulations ;  their 
diagnostic  value  in  any  case  was  contested  by  the  experts  called  by  the 
defense. 

The  court  recognized  that  the  imputed  crime  had  not  been  proved, 
and  exonerated  the  defendants. 

Lesbian  Love.1 

Where  the  sexual  intercourse  is  between  adults,  its  legal 
importance  is  very  slight ;  it  could  come  into  consideration  only 
in  Austria.  In  connection  with  urningism,  this  phenomenon  is 
of  anthropological  and  clinical  value.  The  relation  is  the  same, 
mutatis  mutandis,  as  between  men.  Lesbian  love  does  not 
seem  to  approach  urningism  in  frequency.  The  majority  of 
female  urnings  do  not  act  in  obedience  to  an  innate  impulse, 
but  they  are  developed  under  conditions  analogous  to  those 
which  produce  the  urning  by  cultivation. 

These  "forbidden  friendships"  flourish  especially  in  penal 
institutions  for  females. 

Kraussold  {op.  cit.)  reports  :  "  The  female  prisoners  often  have  such 
friendships,  which,  when  possible,  extend  to  mutual  manustupratiou. 

"  But  temporary  manual  gi'atification  is  not  the  only  purpose  of 
such  friendships.  They  are  made  to  be  enduring, — entered  into  system- 
atically, so  to  speak, — and  intense  jealousy  and  a  passion  for  love  are 

1  Comp.  Mayer,  Friedreich's  Blatter,  1875,  p.  41. — Kraussold,  Melancholic  und 
Schuld,  1884,  p.  20. — Androuico,  Archiv  di  psich.  scienze  penali  ed  antbropol.  crim.,  vol. 
iii,  p.  145. 


LESBIAN    LOVE.  .  429 

developed  which  could  scarcely  be  surpassed  between  persons  of  opposite 
sex.  When  the  friend  of  one  prisoner  is  merely  smiled  at  by  another, 
there  are  often  the  most  violent  scenes  of  jealousy,  and  even  beatings. 

"  When  the  violent  prisoner  has  been  put  in  irons,  in  accordance 
with  the  prison-regulations,  she  says  '  she  has  had  a  child  by  her 
friend.' " 

We  are  indebted  to  Parent-Duchatelet  ("  De  la  prosti- 
tution," 1857,  vol.  i,  p.  159)  for  interesting  communications  con- 
cerning Lesbian  love. 

According  to  this  experienced  author,  repugnance  for  the  most 
disgusting  and  perverse  acts  (coitus  in  axilla,  inter  mammas,  etc.)  which 
men  perform  on  prostitutes  is  not  infrequently  responsible  for  driving 
these  unfortunate  creatures  to  Lesbian  love.  From  his  statements  it  is 
seen  that  it  is  essentially  prostitutes  of  great  sensuality  who,  unsatisfied 
with  intercourse  with  impotent  or  perverse  men,  and  impelled  by  their 
disgusting  practices,  come  to  indulge  in  it. 

Besides  these,  there  are  prostitutes  who  let  themselves  be  known  as 
given  to  tribadism  ;  persons  who  have  been  in  prisons  for  3*ears,  and  in 
these  hot  beds  of  Lesbian  love,  ex  abstinentia,  acquired  this  vice. 

It  is  interesting  to  know  that  prostitutes  hate  those  who  practice 
tribadism, — just  as  men  abhor  pederasts ;  but  female  prisoners  do  not 
regard  the  vice  as  indecent. 

Parent  mentions  the  case  of  a  prostitute  who,  while  intoxicated, 
tried  to  force  another  to  Lesbian  love.  The  latter  became  so  enraged  that 
she  denounced  the  indecent  woman  to  the  police.  Taxil  (op.  cit.  p.  166, 
170)  reports  similar  instances. 

Mantegazza  ("  Anthropol.  culturhistorische  Studien,"  p.  97)  also 
finds  that  sexual  intercourse  between  women  has  especially  the  signifi- 
cance of  a  vice  which  arises  on  the  basis  of  unsatisfied  hyperaesthesia 
sexualis. 

In  many  cases  of  this  kind,  however,  aside  from  congenital  contrary 
sexual  instinct,  one  gains  the  impression  that,  just  as  in  men  (vide 
supra),  the  cultivated  vice  gradually  leads  to  acquired  contrary  sexual 
instinct,  with  repugnance  for  sexual  intercourse  with  the  opposite  sex. 

At  least  Parent's,  cases  were  probably  of  this  nature.  The  corre- 
spondence with  the  lover  was  quite  as  sentimental  and  exaggerated  in 
tone  as  it  is  between  lovers  of  the  opposite  sex ;  unfaithfulness  and  sepa- 
ration broke  the  heart  of  the  one  abandoned  ;  jealousy  was  unbridled,  and 
led  to  bloody  revenge.  The  following  cases  of  Lesbian  love,  by  Mante- 
gazza, are  certainly  pathological,  and  possibly  examples  of  congenital 
contrary  sexual  instinct : — 

1.  On  July  5,  1777,  a  woman  was  brought  before  a  court  in  London, 
who,  dressed  as  a  man,  had  been  married  to  three  different  women.    She 


430  PSYCHOPATHIA   SEXUALIS. 

was  recognized  as  a  woman,  and   sentenced  to   imprisonment   for  six 
months. 

2.  In  1773,  another  woman,  dressed  as  a  man,  courted  a  girl,  and 
asked  for  her  hand ;  but  the  trick  did  not  succeed. 

3.  Two  women  lived  together  as  man  and  wife  for  thirty  years.  On 
her  death-bed  the  "  husband  "  confessed  her  secret  to  those  about  her. 

Coffignon  (op.  cit.,  p.  301)  makes  later  statements  worthy  of  notice. 

He  reports  that  this  vice  is,  of  late,  quite  the  fashion, — partly  owing 
to  novels  on  the  subject,  and  partly  as  a  result  of  excessive  work  on  sew- 
ing-machines, the  sleeping  of  female  servants  in  the  same  bed,  seduction 
in  schools  by  depraved  pupils,  or  seduction  of  daughters  by  perverse 
servants. 

The  author  declares  that  this  vice  ("  saphism ")  is  met  more 
frequently  among  ladies  of  the  aristocracy  and  prostitutes. 

He  does  not  differentiate  physiological  and  pathological  cases, 
nor,  among  the  latter,  the  acquired  and  congenital  cases.  The  details 
of  a  few  cases,  which  are  certainly  pathological,  correspond  exactly 
with  the  facts  that  are  known  about  men  of  contrary  sexuality. 

The  saphists  have  their  places  of  meeting,  recognize  each  other  by 
peculiar  glances,  carriage,  etc.  Saphistic  pairs  like  to  dress  and  orna- 
ment themselves  alike,  etc.  They  are  then  called  " petites  sceurs  "  (little 
sisters). 

7.  Necrophilia.1 
(Austrian  Statutes,  §  306.) 

This  horrible  kind  of  sexual  indulgence  is  so  monstrous 
that  the  presumption  of  a  psychopathic  state  is,  under  all  cir- 
cumstances, justified;  and  Maschka's  recommendation,  that 
the  mental  condition  of  the  perpetrator  should  always  be  in- 
vestigated, is  well  founded.  In  any  case,  an  abnormal  and 
decidedly  perverse  sensuality  is  required  to  overcome  the  natu- 
ral repugnance  which  man  has  for  a  corpse,  and  permit  a 
feeling  of  pleasure  to  be  experienced  in  sexual  congress  with  a 
cadaver. 

Unfortunately,  in  the  majority  of  the  cases  reported,  the 
mental  condition  was  not  examined;  so  that  the  question 
whether  necrophilia  is  compatible  with  mental  soundness  must 
remain  open.  But  any  one  having  knowledge  of  the  horrible 
aberrations  of  the  sexual  instinct  would  not  venture,  without 
further  consideration,  to  answer  the  question  in  the  negative. 

1  Comp.  Maschka,  Hdb.,  iii,  p.  191  (good  historical  notes).— Legrand,  La  folie,  p.  521. 


INCEST.  431 

8.  Incest. 
(Austrian  Statutes,  §  132  ;  Abridgment,  §  189  ;  German  Statutes,  §  174.) 

The  preservation  of  the  moral  purity  of  family  life  is  a 
product  of  civilization;1  and  feelings  of  intense  displeasure 
arise  in  an  ethically  intact  man  at  thought  of  lustful  feeling 
toward  a  member  of  the  same  family.  Only  great  sensuality 
and  defective  ideas  of  laws  and  morals  can  lead  to  incest. 

Both  conditions  may,  in  tainted  families,  be  operative. 
Drinking  and  a  state  of  intoxication  in  men;  weak-minded- 
ness which  does  not  allow  the  development  of  the  feeling  of 
shame,  and  which,  under  certain  circumstances,  is  associated 
with  eroticism  in  females, — these  facilitate  the  occurrence  of 
incestuous  acts.  External  conditions  which  facilitate  their 
occurrence  are  due  to  defective  separation  of  the  sexes  among 
the  lower  classes. 

As  a  decidedly  pathological  phenomenon,  the  author  has 
found  incest  in  states  of  congenital  and  acquired  mental  weak- 
ness, and  infrequently  in  cases  of  epilepsy  and  paranoia. 

In  many  of  the  cases,  probably  a  majority,  it  is  not  pos- 
sible, however,  to  find  a  pathological  basis  for  the  act  which  so 
deeply  wounds  not  only  the  tie  of  blood,  but  also  the  feeling  of 
a  civilized  people.  But  in  many  of  the  cases  reported  in  litera- 
ture, to  the  honor  of  humanity,  the  presumption  of  a  psychopathic 
basis  is  possible. 

In  the  Feldtmann  case  (Marc-Ideler,  vol.  i,  p.  18),  where  a  father 
constantly  made  immoral  attacks  on  his  adult  daughter,  and  finally  killed 
her,  the  unnatural  father  was  weak-minded  and,  besides,  probably  subject 
to  periodical  mental  disease.  In  another  case  of  incest  between  father  and 
daughter  (loc.  cil.,  p.  247),  the  latter,  at  least,  was  weak-minde'd.  Lom- 
broso  (Archiv.  di  Psichiatria,  viii,  p.  519)  reports  the  case  of  a  peasant, 
aged  42,  who  practiced  incest  with  his  daughters,  aged,  respectively,  22, 
19,  and  11 ;  he  even  forced  the  youngest  to  prostitute  herself,  and  then 
visited  her  in  a  brothel.  The  medico-legal  examination  showed  predis- 
position, intellectual  and  moral  imbecility,  and  alcoholism. 

There  was  no  mental  examination  in  the  case  reported  by  Schiir- 
meyer  (Deutsche  Zeitschr.  fur  Staatsarzneikunde,   xxii,  H.  1),  in  which  a 

1  Vide  Westermarck,  History  of  Human  Marriage,  chap.  xiv.    McMillan  &  Co.,  1891. 


432  PSYCHOPATHIA    SEXUALIS. 

mother  laid  her  son  of  five  and  a  half  years  on  herself,  and  practiced  abuse 
with  him  ;  and  in  that  given  byLafarque  (Journ.  Med.  de  Bordeaux,  1814), 
where  a  girl,  aged  17,  laid  her  brother,  aged  13,  upon  herself,  brought 
about  membrorum  conjunctionem,  and  performed  masturbation  on  him. 

The  following  cases  are  those  of  tainted  individuals  :  Magnan  {Ann. 
med.-psych.,  1885)  mentions  an  unmarried  woman,  aged  29,  who,  though 
indifferent  toward  other  children  or  even  men,  suffered  frightfully  in  the 
presence  of  her  nephew,  and  could  scarcely  control  her  impulse  to  cohabit 
with  him.  This  sexual  peculiarity  continued  only  as  long  as  the  nephew 
was  quite  young. 

Legrand  {Ann.  med.-psych.,  May,  1876)  mentions  a  girl,  aged  15, 
who  seduced  her  brother  into  all  manner  of  sexual  excesses  on  her  per- 
son ;  and  when,  after  two  j-ears  of  this  incestuous  practice,  her  brother 
died,  she  attempted  to  murder  a  relative.  In  the  same  article  there  is 
the  case  of  a  married  woman,  aged  36,  who  hung  her  open  breast  out  of 
a  window,  and  indulged  in  abuse  with  her  brother,  aged  18 ;  and  also  the 
case  of  a  mother,  aged  39,  who  practiced  incest  with  her  son,  with  whom 
she  was  madly  in  love,  became  pregnant  by  him,  and  induced  abortion. 

Through  Casper  we  know  that  depraved  mothers  in  large 
cities  sometimes  treat  their  little  daughters  in  a  most  horrible 
fashion,  in  order  to  prepare  them  for  the  sexual  use  of  de- 
bauchees.    This  crime  belongs  elsewhere. 

9.  Immoral  Acts  with  Persons  in  the  Care  of  Others  ;  Seduction 

(Austrian). 

(Austrian  Statutes,  §  131 ;  Abridgment,  §  188  ;  German  Statutes,  §  173). 

Allied  to  incest,  but  still  less  repugnant  to  moral  sensibility, 
are  those  cases  in  which  persons  seduce  those  entrusted  to  them 
for  care  or  education,  and  who  are  more  or  less  dependent  upon 
them,  to  commit  or  suffer  vicious  practices.  Such  acts,  which 
especially  deserve  legal  punishment,  seem  only  exceptionally  to 
have  psychopathic  significance. 


INDEX. 


Abuse,  unnatural,  404 

Acts  for  self-humiliation,  134 

^Esthetics  and  sexuality,  10 

Amor  lesbicus,  428 

Anaesthesia  sexualis,  acquired,  47 

congenital,  42 
Androgyny,  304 
Areas,  erogenous,  31 
Attraction,  sexual,  16 

Baudelaire,  122 

Binet,  18,  19,  21, 121 

Bondage,  sexual,  141 

Bote,  202 

Boys,  whipping  of  (sadistic),  82 

Brunn,  19 

Caesars,  58 

Capitals  as  breeding-places  of  sensuality,  7 

Christianity,  influence  of,  4,  6 

contrasted  with  Mohammedanism,  5 
Cohabitation,  32 
Contrary  sexual  instinct,  185 

causes  of,  188 

degrees  of,  187 
Corpses,  mutilation  of,  67 
Cruelty,  passively  endured,  89 

and  love,  9 

and  lust,  9 

sources  of,  86 

Decadence,  moral,  6 

Defemination,  197 

Defilement  of  women,  79 

Delirium  acutum,  54 

Dementia  and  psychopathia  sexualis,  361 

paretic,  and  psychopathia  sexualis,  363 
Descartes,  162 


Diagnosis  of  contrary  sexuality,  319 
Durga,  57 

Effemination,  279 
Ejaculation  centre,  31 

affections  of,  36 
Epilepsy  and  psychopathia  sexualis,  364 
Equus  eroticus,  111 
Erection  centre,  24 

affections  of,  35 
Esquirol,  220,  221 
Eviration,  197 
Exhibition,  382 
Eyes,  neuropathic,  21 

Family  life,  6 
Fetichism,  17 

and  crime,  401 

of  apron,  170 

of  feathers,  182 

of  female  attire,  167 

of  female  person,  157 

of  foot  and  shoe,  123,  176 

of  furs,  181 

of  hair,  20 

of  hand, 158 

of  handkerchief,  171 

of  glove,  175 

of  material,  180 

of  odors,  21 

of  silk,  183 

of  velvet,  180 

of  voice,  22 

religious,  17 
Fiction  and  sexual  perversion,  123 
Flagellation,  28,  152 

and  masochism,  99 

differentiation  of,  100 

(433) 


434 


INDEX. 


Flagellation,  for  reflex  effect,  99 

heroines  of,  29 
Flagellum  salutis,  20 
Friendship  and  love,  19 
Frigiditas  uxoris,  46 
Frottage,  394 

Gley,  226 
Griesinger,  224 
Gynandry,  304  ; 

Hair,  as  a  fetich,  20 
Hair-despoilers,  162,  164,  165 
Herodotus,  200 
Hermaphroditism,  psychical,  230 

cases  of,  232-255 
Hippocrates,  201 
Homo-sexuality,  185,  255 

acquired,  188 

causes  of,  188 

congenital,  222 

degrees  of,  I,  191;  II,  197?  Ill,  202; 
IV,  216 

explanation  of,  227 
Holder,  202 
Hyperesthesia  sexualis,  48 

cases  of,  51-55 
Hypnosis,  therapeutics,  322-357 
Hysteria,  375 

Idiocy  and  psychopathia  sexualis,  358 
Imbecility  and  contrary  sexuality,  359 
Ink,  throwing  of,  80 
Insanity,  and  contrary  sexuality,  358 

periodical,  372 
Incest,  431 

Japanese  women,  3 
Juvenal,  31 

Kiernan,  227 

Kiernan's  explanation  of  sadism,  152 

Kleist,  83 


Ladame's  case,  344 
Libido  sexualis,  24—32 
Love  and  cruelty,  9 

and  friendship,  19 

and  religion,  8 

fetichism  of,  19 

Lesbian,  428 

of  man  and  woman  compared,  15 

platonic,  11,  12 

true,  11 

youthful,  11 
Lust  and  cruelty,  10,  57 

and  battle,  58,  60 

and  murder,  62,  397 

and  the  passive  endurance  of  cruelty,  90 

and  plunder,  58 
Lupercal,  31 
Lydston,  162,  227 

Magnan,  20,  227 
Mania,  373 
Mantegazza,  7,  227 
Marschalls  Gilles  de  Rays,  58 
Maudsley,  1 
Maeoch,  Sacher-,  89 
Masochism,  89 

and  flagellation,  99 

and  sadism,  148 

explanation  of,  139 

in  women,  137 

larvated,  123 

rudimentary,  101 

symbolic,  115 
Melancholia,  374 
Messalinas,  88 
Metamorphosis  sexualis  paranoica,  216 

transition  to,  202 
Modesty,  origin  of,  2,  15 

in  women,  15 
Mohammedan  women,  5 
Morality,  progress  in,  5 
Morals,  decadence  of,  and  pathology,  6 
Mujerados,  201 


INDEX. 


435 


Necrophilia,  430 
Nervi  erigentes,  24 
Neuroses,  cerebral,  36 

sexual,  34 

spinal,  35 
Nymphomania,  373 

Olfactory  fetichism,  21 

hallucinations  and  sexuality,  28 
sense  and  sexual  sense,  26 

Paradoxia  sexualis,  37 
Paresthesia  sexualis,  56 
Paranoia,  376  -  -  ..' 

Pathological  sexuality  in  its  legal  aspects, 

378 
Pathology,  general,  34 

special,  358 
Pederasty,  408 

cultivated,  414 

false  imputation  of,  420 
Penthesilia,  88 
Perfumes  as  a  fetich,  21,  26 
Physiology,  23 
Priapism,  35 

Prognosis  of  contrary  sexuality,  319 
Psychology,  sexual,  1 
Psychopath  ia  sexualis  periodica,  371 
Puberty,  its  psychological  importance,  7 

relation  to  poetry,  7 
to  religious  feeling,  7 
Pueblo  Indians,  201 

Rape,  397 

Religion  and  sensuality,  8 

Reversal  of  sexual  feeling,  191 

Robbery,  401 

Rousseau,  119 

Sacher-Masoch,  89 
Sade,  Marquis  de,  57,  71 
Sadism,  57,  401 

and  masochism,  148 


Sadism,  atavistic,  152 

cases  of,  62-67 

in  women,  87 

physiological  relations  of,  59 

symbolic,  81   ; 

with  animals,  84 

with  other  objects,  82 
Satyriasis,  373 

Schema  of  sexual  neuroses,  34 
Schopenhauer,  41 
Scythians,  insanity  of  the,  200 
Schrenk-Notzing's  case,  351 
Senile  libido,  40,  41 
Sensuality,  5  

religious  equivalent  of,  8 
Servants,  immoral   acts  of,  with  children 

432 
Sexuality,  source  of  ethical  feeling,  1 

and  the  social  feeling,  1 

simple  reversal  of,  191 
Sexual  attraction,  16 

bondage,  141 

desire,  physiology  of,  23 

instinct  in  childhood,  37 
in  old  age,  38 

promptings,  first,  7 

satisfaction    in    received    cruelty    and 
abuse,  91 

selection,  2 
Shoe-fetichism,  123 

cases  of,  124-134 
Silk-fetichism,  183 
Siva,  57 
Sodomy,  404 
Spanking,  dangers  of,  28 
Stefanowsky,  123 
Sterility,  13 

Sulphuric  acid,  throwing  of,  80 
Suggestion,  hypnotic,  322-357 

Theft,  401 

Torture  of  animals,  401 

Therapy  of  contrary  sexuality,  321 


436 


INDEX. 


Ulrichs,  227 

Urning,  memorial  of  one,  410 

Urnings,  255 

cases  of,  257-279 
laws  concerning,  413 


Vampirism,  87 
Vanity,  16 
Velvet-fetichism,  180 
Violation  of  children,  402 
Viraginity,  279 
Virility,  loss  of,  12 
Voice  as  a  fetich,  22 


Westermarck,  15,  16,  20 
Westphal,  224 
Whitechapel  murderer,  64 
Woman,  elevation  of,  3 

in  Old  Testament  and  Gospels,  4 

position  of,  2 

sexual  appetite  of,  15 
role  of,  13 
Woman-haters'  ball,  417 
Women,  defilement  of,  79 

injury  of,  70 

masochism  in,  137 

Zones,  erogenous,  31 


Revised  Edition,  1892. 


(atalogue 


OF  THE 


Medical 


Publications 


OF 


THE  F.  A.  DAVIS  CO.   Publishers, 
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HiiiililiiiliiiiliiiiiiiiiiiiS 


INDEX   TO   CATALOGUE. 


BOOKS  IN  PKKSS  AND  IN  PREPARATION,  PAGES  31  AND  32. 


PAGE 

Annual   of    the   Universal   Medical 

Sciences 27,  28,  29 

Anatomy. 

Practical  Anatomy — Boenning 4 

Structure  of  the  Central  Nervous  Sys- 
tem— Edinger 8 

Charts  of   the  Nervo-Vascular   System — 

Price  and  Eagleton ".  .   .   .  «17 

Synopsis  of  Human  Anatomy — Young  .   .  25 

Bacteriology. 

Bacteriological  Diagnosis— Eisenberg    .  .       8 

Clinical  Charts. 

Improved  Clinical  Charts—  Bashore  ....       3 

Domestic  Hygiene,  etc. 

The  Daughter:  Her  Health,  Education, 
and  Wedlock — Capp 5 

Consumption  :  How  to  Prevent  it,  etc. — 
Davis 7 

Plain    Talks    on    Avoided    Subjects- 
Guernsey  9 

Heredity,  Health,  and  Personal  Beauty — 
Shoemaker 21 

Electricity. 

Practical  Electricity  in  Medicine  and 
Surgery— Liebig  and  Rohe 12 

Electricity  in  the  Diseases  of  Women — 
Massey 13 

Fever. 

Fever:  its  Pathology  and  Treatment- 
Hare   10 

Hay  Fever— Sajous 20 

Gynecology. 

Lessons  in  Gynecology — Goodell 9 

Practical  Gynecology — Montgomery    ...     32 

Heart,  Lungs,  Kidneys,  etc. 

Diseases   of    the    Heart,   Lungs,    and 

Kidneys— Davis 82 

Diseases  of  the  Heart  and  Circulation  in 
Children — Keating  and  Edwards    ...     12 

Diabetes:    its    Cause,    Symptoms,    and 

Treatment— Purdy 17 

Hygiene. 

Climatology   of    Southern    California — 

Remondino 18 

Text-Book  of  Hygiene—  Rohe" 19 

Materia  Medica  and  Thera- 
peutics. 

Hand-Book  of  Materia  Medica,  Pharmacy, 

and  Therapeutics — Bowen 4 

Ointments  and  Oleates — Shoemaker  ...     21 
Materia  Medica  and  Therapeutics— Shoe- 
maker         22 

'International  Pocket  Medical  Formulary — 
Withsrstine 26 


Miscellaneous. 

Book  on  the  Physician  Himself— Cathell  .  5 

Oxygen — Deinarquay  and  Wallian    ....  7 
Record-Book  of  Medical  Examinations  for 

Life-insurance — Keating 11 

The  Medical  Bulletin,  Monthly 2 

Physician's  Interpreter 13 

Circumcision — Remondino 18 

Medical  Symbolism — Sozinskey 23 

International  Pocket  Medical  Formulary — 

Witherstine 26 

The   Chinese :    Medical,    Political,    and 

Social — Coltman 6 

A  B  C  of  the  Swedish  System  of  Educa- 
tional Gymnastics— Nissen 15 

Lectures  on  Auto-Intoxication — Bouchard  32 

Nervous  System,  Spine,  etc. 

Spinal  Concussion — Clevenger 6 

Structure  of  the  Central  Nervous  System 

—Edinger 8 

Epilepsy :  its  Pathology  and  Treatment — 

Hare 10 

Lectures  on  Nervous  Diseases — Ranney    .  30 

Obstetrics. 

Childbed :  its  Management ;  Diseases  and 

Their  Treatment— Manton     32 

Eclampsia— Michener  and  ethers 13 

Obstetric  Synopsis — Stewart 24 

Physiognomy. 

Practical   and    Scientific    Physiognomy — 
Stanton 30 

Physiology. 

Physiology  of  Domestic  Animals — Smith  .     23 

Surgery  and  Surgical  Operations. 

Practice  of  Surgery — Packard 32 

Tuberculosis  of  theBones  and  Joints — Senn  32 

Circumcision — Remondino 18 

Principles  of  Surgery — Senn 20 

Swedish  Movement  and  Massage. 

Swedish  Movement  and   Massage  Treat- 
ment— Nissen 15 

Throat  and  Nose. 

Journal  of  Laryngology  and  Rhinology    .  11 

Hay  Fever — Sajous 20 

Diphtheria,  Croim  etc.— Sanne 25 

Lectures  on  the  Diseases  of  the  Nose  and 

Throat.    Sajous 31 

Venereal  Diseases. 

Syphilis  To-day  and  in  Antiquity — Buret  4  &  32 
Neuroses  of    the  Genito-Urinary  System 
in  the  Male — Ultzmanu 24 

Veterinary. 

Age  of  Domestic  Animals — Huidekoper   .     11 
Physiology  of  Domestic  Animals — Smith  .     23 

Visiting-Lists  and  Account- 
Books. 

Medical  Bulletin  Visiting-List  or  Physi- 

sicians'  Call-Record 14 

Physicians'  All-Requisite  Account-Book  .     16 


MEDICAL  BULLETIN.   A  Monthly  Journal  of  Medicine  and  Surgery. 

Edited  by  John  V.  Shoemaker,  A.M.,  M.D.  Bright,  original,  and  readable.  Articles 
by  the  best  practical  writers  procurable.  Everv  article  as  brief  as  is  consistent  with  the  preser- 
vation of  its  scientific  'value.  Therapeutic  Notes  by  the  leaders  of  the  medical  profession 
throughout  the  world.  These  and-many  other  unique  features  help  to  keep  The  Medical 
Bulletin  in  its  present,  position  as  the  leading  low-price  Medical  Monthly  of  the  world. 
Subscribe  now. 

TEEMS :  »1.00  a  year  in  advance  in  United  States,  Canada,  and  Mexico. 
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m 


Medical  Publications  of  TJie  F.  A.  Davis  Co.,  Philadelphia. 

Bashore's  Improved  Clinical  Chart. 

For  tlie  Separate  Hotting  of  Temperature,  Pulse,  and  Respiration.    Designed 

for  the  Convenient,  Accurate,  and  Permanent  Daily  Recording 

of  Cases  in  Hospital  and  Private  Practice. 

By  HARVEY  B.  BASHORE,  M.O. 

CUi  So. tmUUU  Data 

Vamo Diagnosis 


COPTKIOHTED,  1888,  BT  T.  A.  DAVIS. 

50  Charts,  in  Tablet  Form.      Size  8  z  12  inches.     Price,  post-paid,  in  the  United 
States  and  Canada,  50  Cents,  net ;  in  Great  Britain,  3s.  6d. ;  in  France,  6  fr.  60. 

The  above  diagram  is  a  little  more  than  one-fifth  (1-5)  the  actnal  site  of  the  chart  and  shows  the  method  of  plotting, 
the  tipper  curve  being  the  Temperature,  the  middle  the  Pulse,  and  the  lower  the  Respiration.  By  this  method  a  full 
record  of  each  can  easily  be  kept  with  but  one  color  ink. 

It  is  so  arranged  that  all  practitioners  will  find  it  an  invaluable  aid  in  the  treatment  of  their  patients. 

On  the  back  of  each  chart  will  be  found  ample  space  conveniently  arranged  for  recording  "  Clinical  History  and 
Symptoms  "  and  "  Treatment." 

By  its  use  the  physician  will  secure  such  a  complete  record  of  his  cases  as,  will  enable  him  to  review  them  at  any 
time.  Thus  he  will  always  have  at  hand  a  source  of  individual  improvement  and  benefit  in  the  practice  of  his  profession, 
the  value  of  which  can  hardly  be  overestimated. 

(3) 


Medical  Publications  of  TJie  F.  A.  Davis  Co.,  Philadelphia. 
BOENNING 

A  Text-Book  on  Practical  Anatomy. 

Including  a  Section  on  Surgical  Anatomy. 

By  Henry  C.  Boenning,  M.D.,  Lecturer  on  Anatomy  and  Surgery  in 
the  Philadelphia  School  of  Anatomy ;  Demonstrator  of  Anatomy  in  the  Medico- 
Chirurgical  College,  etc.,  etc. 

Fully  illustrated  throughout  with  about  200  Wood-Engravings.  In  one 
handsome  Octavo  volume,  printed  in  extra-large,  clear  type,  making  it  specially 
desirable  for  use  in  the  dissecting-room.  Nearly  500  pages.  Substantially  bound 
in  Extra  Cloth.     Also  in  Oil-Cloth,  for  use  in  the  dissecting-room  without  soiling. 

Price,  post-paid,  in  the  United  States,  $2.50,  net ;  Canada  (duty  paid),  $2.75,  net ; 
Great  Britain,  lis. ;  France,  16  fr.  20. 


This  work  is  fully  illustrated  throughout 
with  clear  and  instructive  engravings.  It  is 
not  as  large  as  the  usual  text-books  on  anatomy, 
nor  yet  so  small  as  many  of  the  ready  remem- 


There  is  not  an  unnecessary  word  in  this 
book  of  nearly  five  hundred  pages.  As  a  typo- 
graphical specimen  it  is  elegant.  Systematic, 
comprehensive,    and   intensely   practical,  we 


brances,  but  it  occupies  the  middle  ground,    jj   heartily  commend  it  to  all  medical  students 
and  will  find  an  acceptable  place  with  many   j    and  practitioners. — Denver  Med.  Times. 
students. — Columbus  Med.  Journal. 


BO  WEN 

Hand-Book  of  Materia  Medica,  Pharmacy, 
and  Therapeutics. 

By  Cuthbekt  Bowen,  M.D.,  B.A.,  Editor  of  "  Notes  on  Practice." 
The  second  volume  in  the  Physicians'  and  Students'  Ready  Reference  Series. 
One  12mo  volume  of  370  pages.     Handsomely  bound  in  Dark-Blue  Cloth. 

Price,  post-paid,  in  the  United  States  and  Canada,  $1.40,  net;  in  Great 
Britain,  8s.  6d. ;  in  France,  9  fr.  25. 

This  excellent  manual  comprises  in  its  |j  cated  in  its  title  as  could  well  be  crowded 
366  pages  about  as  much  sound  and  valu-  into  the  compass. — St.  Louis  Medical  and 
able     information     on     the     subjects     indi-  ||  Surgical  Journal. 


BURET 
SYPHILIS    ln  Ancient  and  Prehistoric  Times. 

With  a  Chapter  on  the   Rational  Treatment  of  Syphilis  in  the 
Nineteenth  Century. 

By  Dr.  F.  Buret,  Paris,  France.  Translated  from  the  French,  with  the 
author's  permission,  with  notes,  by  A.  H.  Ohmann-Dumesnil,  Professor  of 
Dermatology  and  Syphilology  in  the  St.  Louis  College  of  Physicians  and  Surgeons. 

No.  12  in  the  Physicians'  and  Students'  Ready-Reference  Series.  230  pages. 
12tno.     Extra  Dark-Blue  Cloth. 

Price,  post-paid,  in  the  United  States  and  Canada,  $1.25,  net;  in  Great 
Britain,  6s.  6i  ;  in  Prance,  7  fr.  75. 

This  volume,  which  is  one  of  a  series  of  three  (the  other  two,  treating  of  Syphilis 
hi  the  Middle  Ages  and  in  modern  times,  now  in  active  preparation),  gives  tbe  most  com- 
plete history  of  Syphilis  from  prehistoric  times  up  to  the  Christian  Era. 

The  subject  throughout  is  treated  in  a  clear,  concise  manner,  and  readers 
will  find  many  things  which  are  historically  new. 

In  order  to  give  some  idea  of  the  contents  of  this  first  volume,  the  following 
are  cited  as  among  the  subjects  treated  : — 

In  What  does  Syphilis  Consist?  Origin  of  the  Word  Syphilis.  The  Age  of 
Syphilis.  Syphilis  in  Prehistoric  Times.  Tchoang. — Syphilis  Among  the  Chinese 
500O  Years  Ago.  Kasa. — Syphilis  in  Japan  in  the  Ninth  Century  B.C.  Syphilis 
Among  the  Ancient  Egyptians,  1400  B.C.  Syphilis  Among  the  Ancient  Assyrians 
and  Babylonians.  Syphilis  Among  the  Hebrews  in  Biblical  Times.  TJpudansa. — 
Syphilis  Among  the  Hindoos,  1000  B.C.  Sukon. — Syphilis  Among  the  Greeks. 
Finis. — Syphilis  at  Rome  under  the  Coesars.  Conclusion  :  Rational  Treatment  of 
Syphilis  in  the  Nineteenth  Century. 

(4) 


Medical  Publications  of  The  F.  A.  Davis  Co.,  Philadelphia. 


CAPP 


Her  Health,  Education,  and 
Wedlock. 


The  Daughter. 

Homely  Suggestions  to  Mothers  and  Daughters. 


By  Willtam  M.  Capp,  M.D.,  Philadelphia.  This  is  just  such  a  book 
as  a  family  physician  would  advise  his  lady  patients  to  obtain  and  read. 
It  answers  many  questions  which  every  busy  practitioner  of  medicine 
has  put  to  him  in  the  sick-room  at  a  time  when  it  is  neither  expedient 
nor  wise  to  impart  the  information  sought. 

It  is  complete  in  one  beautifully  printed  (large,  clear  type)  12mo 
volume  of  150  pages.     Attractively  bound  in  Extra  CUth. 

Price,  post-paid,  in  the  United  States  and  Canada,  $1.00,  net ;  In  Grea, 
Britain,  5s.  6d. ;  France,  6  fr.  20. 

In  the  144  pages  allotted  to  him  he  has  com- 
pressed an  amount  of  homely  wisdom  on  the 
physical,  mental,  and  moral  development  of 
the  female  child  from  birth  to  maturity  which 
is  to  be  found  elsewhere  in  only  the  great 
book  of  experience.  It  is,  of  course,  a  book 
for  mothers,  but  is  one  so  void  of  offense  in 
expression  or  ideas  that  it  can  safely  be  recom- 
mended for  all  whose  minds  are  "sufficiently 
developed  to  appreciate  its  teachings. — Phila- 
delphia Public  L,edger. 

Many   delicate   subjects   are   treated   with 


skill  and  in  a  manner  which  cannot  strike  any 
one  as  improper  or  bold.  The  absolute  ignor- 
ance in  which  most  young  girls  are  allowed  to 
exist,  even  until  adult  life,  is  often  productive 
of  much  misery,  both  mental  and  physical. 
Quite  a  number  of  books  written  by  physi- 
cians for  popular  use  have  been  prepared  in 
such  a  way  that  the  professional  man  can  read 
between  the  lines  strong  bids  for  popular 
favor,  etc.  These  objectionable  features  will 
not  be  found  in  Dr.  Capp's  brochure,  and  for 
this  reason  it  is  worthy  the  confidence  of 
physicians. — Medical  News. 


CATHELL 

Book  on  the  Physician  Himself 

And  Things  that  Concern  his  Reputation  and  Success. 

By  D.  W.  Cathell,  M.D.,  Baltimore,  Md.  Being  the  Ninth  Edition 
(enlarged  and  thoroughly  revised)  of  the  "  Physician  Himself,  and  what 
he  should  add  to  his  Scientific  Acquirements  in  order  to  Secure  Success." 
In  one  handsome  Octavo  Volume  of  298  pages,  bound  in  Extra  Cloth. 

Thousands  of  physicians  have  won  success  in  their  chosen  profession 
through  the  aid  of  this  invaluable  work. 

This  remarkable  book  has  passed  through  eight  (8)  editions  in  less 
than  five  years.  It  has  just  undergone  a  thorough  revison  by  the  author, 
who  has  added  much  new  matter  covering  many  points  and  elucidating 
many  excellent  ideas  not  included  in  former  editions. 

Price,  post-paid,  in  the  United  States  and  Canada,  $2.00,  net;  in  Great 
Britain,  lis.  6cL;  France,  12  fr.  40. 


I  am  most  favorably  Impressed  with  the 
wisdom  and  force  of  tbe  points  made  in  "The 
Physician  Himself,"  and  believe  the  work  in 
the  hands  of  a  young  graduate  will  greatly  en- 
hance his  chances  for  professional  success. — 
From  Prof.  D.  Hayes  Agnew,  J' hi  la.,  Pa. 

We  strorgly  advise  every  actual  and  intend- 
ing practitioner  of  medicine  or  surgery  to  have 
'•  The  Physician  Himself,-'  and  the  more  it  in- 
fluences his  future  conduct  the  better  he  will 
be. — From  the  Canada  Medical  and  Surgical 
Journal,  Montreal. 

In  the  present  edition  the  entire  work  has 
been  revised  and  some  new  matter  introduced. 
The  publisher's  part  is  well  done;  paper  is 
good  and  the  print  large:  altogether  it  is  a 
very  readable  and  enjoyable  book. — Montreal 
Medical  Journal 


We  have  read  it  carefully  and  regret  much 
that  we  had  not  done  so  earlier  and  followed 
its  preoeptB.  The  book  is  full  of  good  advice. 
<iet  it  at  once. — Pacijic  Record  of  Medicine 
and  Surgery, 

We  cannot  imagine  a  more  profitable  invest, 
ment  for  the  junior  practitioner  than  the  pur- 
chase and  careful  Btady  of  "The  Physiciac 
Himself." — Occidental  Medical  Times. 

To  the  physician  who  has  discovered  thai 

there  is  Something  else  besides  dry  hook -learn 
ing  needed  to  make  him  a  desirable  visitor  ai 
the  bedside,  we  commend  this  volume,  that  he 
may  assimilate  some  of  the  ready  crystallized 
worldly  wisdom  which  otherwise  he  may  be 
many  years  acquiring  by  natural  processes. — 
North  Carolina  Medical  Journal. 


(5.> 


Medical  Publications  of  TJie  F.  A.  Davis  Co.,  Philadelphia. 


CLEVENGEK 

Spinal  Concussion. 

Surgically   Considered  as  a   Cause  of   Spinal   Injury,  and  Neuro- 

logically  restricted  to  a  certain  symptom  group,  for  which 

is   Suggested  the  Designation   Erichsen's  Disease, 

as  One  Form  of  the  Traumatic  Neuroses. 

By  S.  V.  Clevenger,  M.D.,  Consulting  Physician  Reese  and  Alexian 
Hospitals ;  Late  Pathologist  County  Insane  Asylum,  Chicago,  etc. 

Special  features  consist  in  a  description  of  modern  methods  of  diag- 
nosis by  Electricity,  a  discussion  of  the  controversy  concerning  hysteria, 
and  the  author's  original  pathological  view  that  the  lesion  is  one  involv- 
ing the  spinal  sympathetic  nervous  system. 

Every  Physician  and  Lawyer  should  own  this  work. 

In  one  handsome  Royal  Octavo  Volume  of  nearly  400  pages,  with 
thirty  Wood-Engravings. 

Price,  post-paid,  in  United  States  and  Canada,  $2.50,  net ;  in  Great 
Britain,  Us.;  in  France,  15  fr. 


This  work  really  does,  if  we  may  be  per- 
mitted to  use  a  trite  and  hackneyed  expres- 
sion, "fill  a  long-felt  want."  The  subject  is 
treated  in  all  its  bearings;  electro-diagnosis 


receives  a  large  share  of  attention,  and  the 
chapter  devoted  to  illustrative  cases  will  be 
found  to  possess  especial  importance. — Med- 
ical Weekly  Review. 


COLTMAF 


the  CHINESE: 


Their  Present  and  Future; 
Medical,  Political,  and  Social. 


By  Robert  Coltman,  Jr.,  M.D.,  Surgeon  in  Charge  of  the  Presby- 
terian Hospital  and  Dispensary  at  Teng  Chow  Fu  ;  Consulting  Phy- 
sician of  the  American  Southern  Baptist  Mission  Society,  etc. 

Beautifully  printed  in  large,  clear  type,  illustrated  with  Fifteen  Fine 
Engravings  on  Extra  Plate  Paper,  from  photographs  of  persons,  places, 
and  objects  characteristic  of  China.  . 

In  one  Royal  Octavo  volume  of  212  Pages.  Handsomely  bound  in 
Extra  Cloth,  with  Chinese  Side  Stamp  in  gold. 

Price,  post-paid,  in  United  States  and  Canada,  $1.75,  net;  in  Great 
Britain,  10s. ;  in  France,  12  fr.  20. 


The  Chinaman  is  a  source  of  absolute  curi- 
osity to  the  American,  and  anything  in  regard 
to  his  relationship  to  the  medical  profession 
will  prove  more  than  usually  attractive  to  the 
average  doctor.  Such  is  the  case  with  the 
work  before  us.  It  is  difficult  to  put  it  aside 
after  one  has  begun  to  read  it. — Memphis  Med. 
Monthly. 

Dr.  Coltman  has  written  a  very  readable 
book,  illustrated  with  reproductions  of  photo- 
graphs taken  by  himself. — Boston  Med.  and 
Surg.  Journal. 

Attached  to  a  number  of  hospitals  and  dis- 
pensaries, he  has  had  ample  opportunity  to 
observe  the  medical  aspect  of  the  Chinese. 
The  most  prevalent  diseases  are  such  as  affect 
the  alimentary  tract  and  eye  troubles.  Renal 
troubles  are  also  frequent.  Skin  diseases  are 
abundant  and  syphilis  is  far  from  infrequent. 


Erysipelas  is  rare  and  enteric  fever  infrequent. 
Cholera  appears  in  epidemics  and  is  then 
frightfully  fatal.  Leprosy,  of  course,  is  com- 
mon, and  "the  author  states  that  it  cannot  be 
contagious,  as  is  supposed  by  many,  or  it 
wouldassunie  a  terrible  prevalence  in  China, 
where  lepers  are  permitted  to  go  about  free. 

We  will  not  further  mention  the  subjects 
discussed  in  this  excellent  book.  The  style  of 
the  author  is  very  interesting  and  taking,  and 
much  information  is  given  in  an  entertaining 
manner.  The  politicalsituation  is  very  intelli- 
gently handled  in  its  various  bearings.  The 
photo-engravings  are  handsome  and  well-ex- 
ecuted, the  book  in  general  being  gotten  up  in 
a  very  artistic  manner.  We  can  heartily  com- 
mend this  work  not  only  to  physicians,  but  to 
intelligent  lay  readers. — St.  Louis  Medical 
Review. 


(6) 


Medical  Publications  of  The  F.  A.  Davis  Co.,  Philadelphia. 
DAVIS 

CONSUMPTION:  How  t0  p^m  ?"d  "°w  to 

Its   Nature,  Causes,  Prevention,  and  the   Mode  of  Life,  Climate, 
Exercise,  Food,  and  Clothing  Necessary  for  its  Cure. 

By  N.  S.  Davis,  Jr.,  A.M.,  M.  D.,  Professor  of  Principles  and  Practice  of 
Medicine,  Chicago  Medical  College  ;  Physician  to  Mercy  Hospital,  Chicago ; 
Member  of  the  American  Medical  Assoeiation,  etc. 

This  plain,  practical  treatise  thoroughly  discusses  the  prevention  of  Con- 
sumption, Hygiene  for  Consumptives,  gives  timely  suggestions  concerning  the 
different  climates  and  the  important  part  they  play  in  the  treatment  of  this  disease, 
etc.,  etc., — all  presented  in  such  a  succinct  and  intelligible  style  as  to  make  the 
perusal  of  the  book  a  pleasant  pastime. 

In  one  neat  12mo  volume  of  143  pages.  Handsomely  bound  in  Extra  Cloth, 
with  Back  and  Side  Stamps  in  Gold. 

Price,  post-paid,  in  United  States  and  Canada,  75  Cents,  net ;  in  Great 
Britain,  4s. ;  in  Prance,  i  fr. 


The  questions  of  heredity,  predisposition, 
prevention,  and  hygienic  treatment  of  con- 
sumption are  simply  and  sensibly  dealt  with. 
The  chapters  on  how  to  live  with  tuberculosis 
are  excellent. — Indiana  Medical  Journal. 

The  author  is  very  thorough  in  his  dis- 
cussion of  the  subject,  and  the  practical  hints 
which  he  gives  are  of  real  worth  and  value. 


His  directions  are  given  in  such  a  manner  as 
to  make  life  enjoyable  to  a  consumptive 
patient  and  not  a  burden,  as  is  too  frequently 
the  case.—  Weekly  Medical  Review. 

There  is  much  good  ordinary  common 
sense  in  this  book  of  only  150  pages.  The  part 
of  the  brochure  devoted  to  Climatology  is  espe- 
cially commendable. — Denver  Medical  Times. 


DEMARQUAY 

f\       f\  A  Practical  Investigation  of  the  Clinical 

UP!    UXVQCn.         and  Therapeutic  Value  of  the  Oases 
J  **  in  medical  and  Surgical  Practice, 

With  Especial  Reference  to  the  Value  and  Availability  of  Oxygen 
Nitrogen,  Hydrogen,  and  Nitrogen  Monoxide. 

By  J.  N.  Demarquay,  Surgeon  to  the  Municipal  Hospital,  Paris,  and  of  the 
Council  of  State ;  Member  of  the  Imperial  Society  of  Surgery,  etc.  Translated, 
with  notes,  additions,  and  omissions,  by  Samuel  S.  Wallian,  A.M.,  M.D.;  Ex- 
President  of  the  Medical  Association  of  Northern  New  York  ;  Member  of  the  New 
York  County  Medical  Society,  etc. 

In  one  handsome  Octavo  Volume  of  316  pages,  printed  on  fine  paper,  in  the 
best  style  of  the  printer's  art,  and  illustrated  with  21  Wood-Cuts. 

Price,  post-paid,  in  United  States  and  Canada,  Cloth,  $2.00,  net;  Half- 
Russia,  $3.00,  net.  In  Great  Britain,  Cloth,  lis.  Gd. ;  Half-Russia, 
17s.  6i    In  Trance,  Cloth,  12  fr.  40;  Half-Russia,  18  fr.  GO. 

For  some  years  past  there  has  been  a  growing  demand  for  something  more 
satisfactory  and  more  practical  in  the  way  of  literature  on  the  subject  of  aero- 
therapeutics.  On  all  sides  professional  men  of  standing  and  ability  are  turning 
their  attention  to  the  use  of  the  gaseous  elements/ as  remedies  in  disease,  as  well 
as  sustainers  in  health.  In  prosecuting  their  inquiries,  the  first  hindrance  has 
been  the  want  of  any  reliable  or  satisfactory  literature  on  the  subject. 

This  work,  translated  from  the  French  of  Professor  Demarquay,  contains 
also  a  very  full  account  of  recent  English,  German,  and  American  experiences, 
prepared  by  Dr.  Samuel  S.  Wallian,  of  New  York,  whose  experience  in  this  field 
has  been  more  extensive  than  that  of  any  other  American  writer  on  the  subject. 


This  is   a  handsome  volume  of  300  pages,   | 
in  large  print,  on  good  paper,  and  nicelv  ill  us-  | 
trated.    Although  nominally  pleading  for  the 
use  of  oxygen  inhalations,  the  author  shows  in  | 
a   philosophical    manner    how  much   greater  I 
good  physicians  might  do  if  they  more  fully  ; 
appreciated  the  value  of  fresh-air  exercise  and 
water,  especially  in  diseases  of  the  lungs,  kid- 
neys, and  skin.    We  commend  its  perusal  to 
our  readers. — The  Canada  Medical  Record. 


The  book  should  be  widely  read,  for  to 
many  it  will  bring  the  addition  of  a  new 
weapon  to  their  therapeutic  armament. — 
Northwestern  Lancet. 

Altogether  the  book  is  a  valuable  one, 
which  will  be  found  of  service  to  the  busv 
practitioner  who  wishes  to  keep  abreast  of 
the  improvements  in  therapeutics. — Medical 
News. 


(V) 


Medical  Publications  of  The  F.  A.  Davis  Co.,  Philadelphia. 
EISENBERG 

Bacteriological  Diagnosis. 

Tabular  Aids  for  Use  in  Practical  Work. 

By  James  Eisenberg,  Ph.D.,  M.D.,  Vienna.  Translated  and  augmented, 
with  the  permission  of  the  author,  from  the  second  German  Edition,  by  Norval 
H.  Pierce,  M.D.,  Surgeon  to  the  Out-Door  Department  of  Michael  Reese 
Hospital  ;  Assistant  to  Surgical  Clinic,  College  of  Physicians  and  Surgeons, 
Chicago,  111. 

Nearly  200  pages.  In  one  Royal  Octavo  volume,  handsomely  hound  in 
Cloth  and  in  Oil-Cloth  (for  lahoratory  use). 

Price,  post-paid,  in  the  United  States  and  Canada,  $1.50,  net;  in  Great 
Britain,  8s.  6d. ;  in  France,  9  fr.  35. 

This  hook  is  a  novelty  in  Bacteriological  Science.  It  is  a  work  of  great 
importance  to  the  teacher  as  well  as  to  the  student.  It  will  be  of  inestimable 
value  to  the  private  worker,  and  is  designed  throughout  as  a  practical  guide  in 
laboratory  work.  It  is  arranged  in  a  tabular  form,  in  which  are  given  the  specific 
characteristics  of  the  various  well  established  bacteria,  so  that  the  worker  may,  at 
a  glance,  inform  himself  as  to  the  identity  of  a  given  organism. 

There  is  also  an  appendix,  in  which  is  given,  in  a  concise  and  practical  form, 
the  technique  employed  by  the  best  laboratories  in  the  cultivation  and  staining 
of  bacteria  ;  the  composition  and  preparation  of  the  various  solid,  semi-solid,  and 
fluid  media,  together  with  their  employment  ;  a  complete  list  of  stains  and  re- 
agents, with  formulas  for  same  ;  the  methods  of  microscopic  examination  of 
bacteria,  etc. ,  etc.,  etc. 


EDIJVGEB 

Twelve  Lectures  on  the  Structure  of  the 
Central  Nervous  System. 

For  Physicians  and  Students. 

By  Dr.  Ludwig  Edinger,  Frankfort-on-the-Main.  Second  Revised  Edi- 
tion. With  133  Illustrations.  Translated  by  Willis  Hall  Vitttjm,  M.D.,  St. 
Paul,  Minn.  Edited  by  C.  Eugene  Riggs,  A.M  ,  M.D.,  Professor  of  Mental  and 
Nervous  Diseases,  University  of  Minnesota  ;  Member  of  the  American  Neuro- 
logical Association. 

The  illustrations  are  exactly  the  same  as  those  used  in  the  latest  German 
edition  (with  the  German  names  translated  into  English),  and  are  very  satisfac- 
tory to  the  Physician  and  Student  using  the  book. 

The  work  is  complete  in  one  Royal  Octavo  Volume  of  about  250  pages, 
bound  in  Extra  Cloth. 

Price,  post-paid,  in  the  United  States  and  Canada,  $1.75,  net;  in  Great 
Britain,  10s. ;  in  France,  12  fr.  20. 


One  of  the  most  instructive  and  valuable 
works  on  the  minute  anatomy  of  the  human 
brain  extant.  It  is  written  in  the  form  of 
lectures,  profusely  illustrated,  and  in  clear 
language. — 77ie  Pacific  Record  of  Medicine 
and  Surgery. 

Since  the  first  works  on  anatomy,  up  to  the 
present  day.  no  work  has  appeared' on  the  sub- 
ject of  the  general  and  minute  anatomy  of  the 
central  nervous  system  so  complete  and  ex 


succeeded  in  transforming  the  mazy  wilder- 
ness of  nerve  fibres  and  cells  into  a  district  of 
well-marked  pathways  and  centres,  and  by  so 
doing  lias  made  a  pleasure  oirt  of  an  anatom- 
ical bugbear.— The  Southern  Medical  Record. 

Everv  point  is  clearly  dwelt  upon  in  the  text, 
and  where  description  alone  might  leave  a 
subject  obscure  clever  drawings  and  diagrams 
are  introduced  tn  render  misconception  of  the 
author's  meaning   impossible.     The  book    is 


haustive  as  this  work  of  Dr.  Ludwig  Edinger.  !    eminently  practical.    It  unravels  the  intricate 

Being  himself  an  original  worker,  and  having  i  entanglement  of  different  tracts  and  paths  in 

the  benefits  of  such  masters  as  Stilling,  Wei-  away  that  no  other  book  has  done  so  explic- 

geit,  Geilach,   Meynert,  and   others,  he  has  ||  itly  or  so  concisely.— Northwestern  Lancet. 

(8) 


Medical  Publications  of  The  F.  A.  Davis  Co.,  Philadelphia. 


GOODELL 

Lessons  in  Gynecology. 

By  William  Goodell,  A.M.,  M.D.,  etc.,  Professor  of  Clinical  Gyne- 
cology in  the  University  of  Pennsylvania. 

This  exceedingly  valuable  work,  from  one  of  the  most  eminent 
specialists  and  teachers  in  gynecology  in  the  United  States,  is  now- 
offered  to  the  profession  in  a  much  more  complete  condition  than  either 
of  the  previous  editions.  It  embraces  all  the  more  important  diseases 
and  the  principal  operations  in  the  field  of  gynecology,  and  brings  to 
bear  upon  them  all  the  extensive  practical  experience  and  wide  reading 
of  the  author.  It  is  an  indispensable  guide  to  every  practitioner  who 
has  to  do  with  the  diseases  peculiar  to  women.  Third  Edition.  With 
112  illustrations.  Thorough!}"  revised  and  greatly  enlarged.  One  volume, 
large  octavo,  578  pages. 

Price,  in  United  States  and  Canada,  Cloth,  $5.00 ;  Full  Sheep,  $6.00.    Discount, 

20  per  cent.,  making  it,  net,  Cloth,  $4.00 ;  Sheep,  $1.80.    Postage,  27 

cents  extra.     Great  Britain,  Cloth,  22s.  6i  ;  Sheep,  28s., 

post-paid.    France,  30  fr.  80. 


It  is  too  good  a  book  to  have  been  allowed  to 
remain  out  of  print,  and  it  has  unquestionably 
been  missed.  The  author  has  revised  the  work 
with  special  care,  adding  to  each  lesson  such 
fresh  matter  as  the  progress  in  the  art  ren- 
dered necessary,  and  he  has  enlarged  it  by  the 
insertion  of  six  new  lessons.  This  edition  will, 
without  question,  be  as  eagerly  sought  for  as 
were  its  predecessors. — American  Jovrnal  of 
Obstetrics. 

His  literary  style  is  peculiarly  charming. 
There  is  a  directness  and  simplicity  about  it 
which  is  easier  to  admire  than  to  copy.  His 
chain  of  plain  words  and  almost  blunt  expres- 
sions, his  familiar  comparison  and  homely 
illustrations,  make  his  writings,  like  his  lec- 


tures, unusually  entertaining.  The  substance 
of  his  teachings  we  regard  as  equally  excel- 
lent.— Philadelphia  Medical  and  Surgical 
Reporter. 

Extended  mention  of  the  contents  of  the 
book  is  unnecessary;  suffice  it  to  say  that 
every  important  disease  found  in  the  female 
sex  is  taken  up  and  discussed  in  a  comiuon- 
sense  kind  of  a  way.  We  wish  every  physician 
in  America  could  read  and  carry  out  the  sug- 
gestions of  the  chapter  on  "the  sexual  rela- 
tions as  causes  of  uterine  disorders — conjugal 
onanism  and  kindred  sins.''  The  department 
treating  of  nervous  counterfeits  of  uterine 
diseases  is  a  most  valuable  one. — Kansas  City 
Medical  Index. 


GUERNSEY 

Plain  Talks  on  Avoided  Subjects. 

By  Henry  N.  Guernsey,  M.D.,  formerly  Professor  of  Materia  Medica 
and  Institutes  in  the  Hahnemann  Medical  College  of  Philadelphia ; 
author  of  Guernsey's  "  Obstetrics,"  including  the  Disorders  Peculiar  to 
Women  and  Young  Children  ;  Lectures  on  Materia  Medica,  etc.  The 
following  Table  of  Contents  shows  the  scope  of  the  book : 

Contents. — Chapter  I.  Introductory.  II.  The  Infant.  III.  Child- 
hood. IV.  Adolescence  of  the  Mnle.  V.  Adolescence  of  the  Female. 
VI.  Marriage:  The  Husband.  VII.  The  Wife.  VIII.  Husband  and 
Wife.  IX.  To  the  Unfortunate.  X.  Origin  of  the  Sex.  In  one  neat 
16mo  volume,  bound  in  Extra  Cloth. 

Price,  post-paid,  in  the  United  States  and  Canada,  $1.00 ;  Great  Britain, 
6s. ;  France,  6  fr.  20. 


Medical  Publications  of  Tlie  F.  A.  Davis  Co.,  Philadelphia. 


HARE 

Epilepsy:  Its  Pathology  and  Treatment. 

Being  an  Essay  to  which  was  Awarded  a  Prize  of  Four  Thousand 

Francs  by  the  Academie  Royale  de  Medecine  de  Belgique, 

December  31,  1889. 

By  Hobart  Amort  Hare,  M.D.  (Univ.  of  Penna.),  B.Sc,  Professor  of 
Materia  Medica  and  Therapeutics  in  the  Jefferson  Medical  College,  Phila.  ; 
Physician  to  St.  Agnes'  Hospital  and  to  the  Children's  Dispensary  of  the  Chil- 
dren's Hospital ;  Laureate  of  the  Royal  Academy  of  Medicine  in  Belgium,  of 
the  Medica]  Society  of  London,  etc.  ;  Member  of  the  Association  of  American 
Physicians. 

No.  7  in  the  Physicians'  and  Students'  Beady -liefer  ence  Series.  12mo.  228 
pages.     Neatly  bound  in  Dark -blue  Cloth. 

Price,  post-paid,  in  United  States  and  Canada,  $1.25,  net ;  in  Great 
Britain,  6s.  6d. ;  in  Prance,  7  fr.  75. 


It  is  representative  of  the  most  advanced 
views  of  the  profession,  and  the  subject  is 
pruned  of  the  vast  amount  of  superstition  and 
nonsense  that  generally  obtains  in  connection 
with  epilepsy. — Medical  Age. 

Every  physician  who  would  get  at  the  gist 
of  all  that  is  worth  knowing  on  epilepsy,  and 
who  would  avoid  useless  research  among  the 
mass  of  literary  nonsense  which  pervades  all 
medical  libraries,  should  get  this  work." — The 
Sanitarian. 

It  contains  all  that  is  known  of  the  pathology 
of  this  strange  disorder,  a  clear  discussion  of 
the  diagnosis  from  allied,  neuroses,  and  the 
very  latest  therapeutic  measures  for  relief. 


It  is  remarkable  for  its  clearness,  brevity,  and 
beauty  of  style.  It  is,  so  far  as  the  reviewer 
knows,  altogether  the  best  essay  ever  written 
upon  this  important  subject. — Kansas  City 
Medical  Index. 

The  task  of  preparing  the  work  must  have 
been  most  laborious,  but  we  think  that  Dr. 
Hare  will  be  repaid  for  his  efforts  by  a  wide 
appreciation  of  the  work  by  the  profession ; 
for  the  book  will  be  instructive  to  those  who 
have  not  kept  abreast  with  the  recent  litera- 
ture upon  this  subject.  Indeed,  the  work  is  a 
sort  of  Dictionary  of  epilepsy — a  reference 
guide-book  upon  the  subject. — Alienist  and 
[Neurologist. 


HARE 

Fever:  Its  Pathology  and  Treatment. 

Being  the  Boylston  Prize  Essay  op  Harvard  University  for  1890. 
Containing  Directions  and  the  Latest  Information  Con- 
cerning the   Use  of  the   So-Called  Anti- 
pyretics in  Fever  and  Pain. 

By  Hobart  Amory  Hare,  M.D.  (Univ.  of  Penna.),  B.Sc,  Professor  of 
Materia  Medica  and  Therapeutics  in  the  Jefferson  Medical  College,  Phila.; 
Physician  to  St.  Agnes'  Hospital  and  to  the  Children's  Dispensary  ef  the  Chil- 
dren's Hospital;  Laureate  of  the  Royal  Academy  of  Medicine  in  Belgium,  of  the 
Medical  Society  of  London,  etc.;  Member  of  the  Association  of  American 
Physicians. 

No.  10  in  the  Physicians'  and  Students'  Ready-Reference  Series.  12mo. 
Neatly  bound  in  Dark-blue  Cloth. 

Illustrated  with  more  than  25  new  plates  of  tracings  of  various  fever  cases, 
showing  beautifully  and  accurately  the  action  of  the  Antipyretics.  The  work 
also  contains  35  carefully  prepared  statistical  tables  of  249  cases  showing  the 
untoward  effects  of  the  antipyretics. 

Price,  post-paid,  in  the  United  States  and  Canada,  $1.25,  net ;  in  Great  Britain, 
6s.  6d. ;  in  Prance,  7  fr.  75. 


As  is  usual  with  this  author,  the  subject  is 
thoroughly  handled,  and  much  experimental 
and  clinical  evidence,  both  from  the  author's 
experience  and  that  of  others,  is  adduced  in 
support  of  the  view  taken. — New  York  Medical 
Abstract. 

The  author  has  done  an  able  piece  of  work 
in  showing  the  facts  as  far  as  they  are  known 
concerning  the  action  of  antipyrin,  anti- 
febrin,  phenacetin,  thallin,  and  salicylic  acid. 
The  reader  will  certainly  find  the  work  ome  of 


the  most  interesting  of  its  excellent  group, 
the  Physicians'  and  Students'  Ready-Refer- 
ence Series. — 27ie  Dosimetric  Medical  Review. 

Such  books  as  the  present  one  are  of  service 
to  the  student,  the  scientific  therapeutist,  and 
the  general  practitioner  alike,  for  much  can 
be  found  of  real  value  in  Dr.  Hare's  book,  with 
the  additional  advantage  that  it  is  up  to  the 
latest  researches  upon  the  subject. — Univer- 
sity Medical  Magazine. 


(10) 


Medical  Publications  of  The  F.  A.  Davis  Co.,  Philadelphia. 


HUIDEKOPBR 

Age  of  the  Domestic  Animals. 

Being   a  Complete   Treatise  on   the   Dentition  of   the   Horse,  Ox, 

Sheep,  Hog,  and  Dog,  and  on  the  Various  Other  Means  of 

Determining  the  Age  of  these  Animals. 

By  Rush  Shippen  Huidekoper,  M.D.,  Veterinarian  (Alfort,  France)  ;  Professor  of 
Sanitary  Medicine  and  Veterinary  Jurisprudence,  American  Veterinary  College,  New  York  ; 
Late  Dean  of  the  Veterinary  Department,  University  of  Pennsylvania. 

Complete  in  one  handsome  Royal  Octavo  volume  of  225  pages,  bound  in  Extra  Cloth. 
Illustrated  with  200  engravings. 

Price,  post-paid,  in  the  United  States  and  Canada,  $1.75,  net ;  in  Great 
Britain,  10s. ;  in  France,  12  fr.  20. 

This  work  presents  a  careful  study  of  all  that  has  been  written  on  the  subject  from 
the  earliest  Italian  writers.  The  author  has  drawn  much  valuable  material  from  the  ablest 
English,  French,  and  German  writers,  and  has  given  his  own  deductions  and  opinions, 
•whether  they  agree  or  disagree  with  such  investigators  as  Bracy  Clark,  Simouds  (in  Eng- 
lish), Girard,  Chauveau,  Leyh,  Le  Coque,  Goubaux,  and  Barrier  (in  German  and  French). 


The  literary  execution  of  the  book  is  very 
satisfactory,  the  text  is  profusely  illustrated, 
and  the  student  will  find  abuudant  means  in 
the  cuts  for  familiarizing  himself  with  the 
various  aspects  presented  by  the  incisive 
arches  during  the  different  stages  of  life. 
Illustrations  do  not  always  illustrate ;  these 
do. — Amer.  Vet.  Review. 

Although  written  primarily  for  the  veteri- 


narian, this  book  will  be  of  interest  to  the 
dentist,  physiologist,  anatomist,  and  physician. 
Its  wealth  of  illustration  and  careful  prepara- 
tion are  alike  commendable.— Chicago  Med. 
Recorder. 

It  is  profusely  illustrated  with  200  engrav- 
ings, and  the  text  forms  a  study  well  worth  the 
price  of  the  book  to  every  dental  practitioner. 
— Ohio  Journal  of  Dental  Sciences. 


Journal  of  Laryngology,  Rhinology, 
and  Otology. 

An  Analytical  Record  of   Current    Literature    Relating  to  the 
Throat,  Nose,  and  Ear.     Issued  on  the  First  of  Each  Month. 

Edited  by  Dr.  Ncniris  Wolfenden,  of  London,  and  Dr.  John  Macintyre,  of  Glas- 
gow, with  the  active  aid  and  co-operation  of  Drs.  Dundas  Grant,  Barclay  J.  Baron,  and 
Hunter  Mackenzie.  Besides  those  specialists  in  Europe  and  America  who  have  so  ably 
assisted  in  the  collaboration  of  the  Journal,  a  number  of  new  correspondents  have  under- 
taken to  assist  the  editors  in  keeping  the  Journal  up  to  date,  and  furnishing  it  with  matters 
of  interest.  Amongst  these  are:  Drs.  Sajous,  of  Philadelphia;  Mhidlemass  Hunit,  of 
Liverpool ;  Mellow,  of  Rio  Janeiro  ;  Sedziak,  of  Warsaw  ;  Draispul,  of  St.  Petersburg,  etc. 
Drs.  Michael,  Joal,  Holger  Mygind,  Prof.  Massei,  and  Dr.  Valerius  Idelson  will  still  collab- 
orate the  literature  of  their  respective  countries. 

Price,  13s.  or  $3.00  per  annum  (inclusive  of  Postage).    For  single  copies,  however, 
a  charge  of  Is.  3d.  (30  Cents)  will  be  made.    Sample  Copy,  25  Cents. 


KEATING 

Record-Book  of  Medical  Examinations 

For  Life-Insurance. 

Designed  by  John  M.  Keating,  M.D. 

This  record-book  is  small,  neat,  and  complete,  and  embraces  all  the  principal  points 
that  are  required  by  the  different  companies.  It  is  made  in  two  sizes,  viz.  :  No.  1,  covering 
one  hundred  (100)  examinations,  and  No.  2,  covering  two  hundred  (200)  examinations. 
The  size  of  the  book  is  7  x  '6%  inches,  and  can  be  conveniently  carried  in  the  pocket. 

U.  S.  and  Canada.       Great  Britain.       France. 


No.  1.    For  100  Examinations,  in  Cloth,    -    -    $  ,50,  Net 
No.  2.    For  200  Examinations,  in  Full 

Leather,  with  Side  Flap,  -    -    -    -      1.00,    " 

(ii) 


3s.  6d. 


6s. 


3fr.  60 


6fr.  20 


Medical  Publications  of  The  F.  A.  Davis  Co.,  Philadelphia. 
KEATING  and  EDWARD S 

Diseases  of  the  Heart  and  Circulation. 

In  Infancy  and  Adolescence.     With  an  Appendix  entitled  "  Clinical 
Studies  on  the  Pulse  in  Childhood." 

By  John  M.  Keating,  M.D.,  Obstetrician  to  the  Philadelphia  Hospital, 
and  Lecturer  on  Diseases  of  Women  and  Children;  Surgeon  to  the  Maternity 
Hospital;  Physician  to  St.  Joseph's  Hospital;  Fellow  of  the  College  of  Physicians 
of  Philadelphia,  etc.;  and  William  A.  Edwards,  M.D.,  Instructor  in  Clinical 
Medicine  and  Physician  to  the  Medical  Dispensary  in  the  University  of 
Pennsylvania;  Physician  to  St.  Joseph's  Hospital;  Fellow  of  the  College  of 
Physicians;  formerly  Assistant  Pathologist  to  the  Philadelphia  Hospital,  etc. 

Illustrated  by  Photographs  and  Wood-Engravings.  About  225  pages.  Oc- 
tavo.    Bound  in  Cloth. 

Price,  post-paid,  in  the  United  States  and  Canada,  $1.50,  net;  in  Great 
Britain,  8s.  6d. ;  in  France,  9  fr.  35. 


Drs.  Keating  and  Edwards  have  produced  a 
work  that  will  give  material  aid  to  every 
doctor  in  his  practice  among  children.  The 
style  of  the  hook  is  graphic  and  pleasing,  the 
diagnostic  points  are  explicit  and  exact,  and 
the  therapeutical  resources  include  the  novel- 
ties of  medicine  as  well  as  the  old  and  tried 
agents.— Pittsburgh  Med.  Review. 


It  is  not  a  mere  compilation,  hut  a  systematic 
treatise,  and  bears  evidence  of  considerable 
labor  and  observation  on  the  part  of  the 
authors.  Two  fine  photographs  of  dissections 
exhibit  mitral  stenosis  and  mitral  regurgita- 
tion ;  there  are  also  a  number  of  wood-cuts. 
— Cleveland  Medical  Gazette. 


LIEBIG  and  ROSE 

Practical  Electricity  in  Medicine  $  Surgery. 

By  O.  A.  Liebig,  Jr.,  Ph  D.,  Assistant  in  Electricity,  Johns  Hopkins 
University  ;  Lecturer  on  Medical  Electricity,  College  of  Physicians  and  Surgeons, 
Baltimore  ;  Member  of  the  American  Institute  of  Electrical  Engineers,  etc.  ;  and 
George  H.  Rohe,  M.D.,  Professor  of  Obstetrics  and  Hygiene,  College  of  Physi- 
cians and  Surgeons,  Baltimore  ;  Visiting  Physician  to  Bay  View  and  City  Hos- 
pitals ;  Director  of  the  Maryland  Maternite  ;  Associate  Editor  "Annual  of  the 
Universal  Medical  Sciences,"  etc. 

Profusely  Illustrated  by  Wood-Engravings  and  Original  Diagrams,  and 
published  in  one  handsome  Royal  Octavo  volume  of  383  pages,  bound  in  Extra 
Cloth. 

The  constantly  increasing  demand  for  this  work  attests  its  thorough  relia- 
bility and  its  popularity  with  the  profession,  and  points  to  the  fact  that  it  is 
already  the  standard  work  on  this  very  important  subject.  The  part  on  Ph}rsical 
Electricity,  written  by  Dr.  Liebig,  one  of  the  recognized  authorities  on  the 
science  in  the  United  States,  treats  fully  such  topics  of  interest  as  Storage  Bat- 
teries, Dynamos,  the  Electric  Light,  and  the  Principles  and  Practice  of  Electrical 
Measurement  in  their  Relations  to  Medical  Practice.  Professor  Rohe,  who  writes 
on  Electro-Therapeutics,  discusses  at  length  the  recent  developments  of  Electricity 
in  the  treatment  of  stricture,  enlarged  prostate,  uterine  fibroids,  pelvic  cellulitis, 
and  other  diseases  of  the  male  and  female  genito-urinary  organs.  The  applica- 
tions of  Electricity  ki  dermatology,  as  well  as  in  the  diseases  of  the  nervous 
system,  are  also  fully  considered. 

Price,  post-paid,  in  the  United  States  and  Canada,  $2.00,  net ;  in  Great 
Britain,  lis.  6d. ;  France,  12  fr.  40. 


Any  physician,  especially  if  he  be  a  beginner 
in  electro-therapeutics,  will  be  well  repaid  by 
a  careful  study  of  this  work  by  Liebig  and 
Rohe.  For  a  work  on  a  special  subject  the 
price  is  low,  and  no  one  can  give  a  good  ex- 
cuse for  remaining  in  ignorance  of  so  impor- 
tant a  subject  as  electricity  in  medicine.— 
Toledo  Medical  and  Surgical  Reporter. 

The  entire  work  is  thoroughly  scientific  and 
practical,  and  is  really  what  the  authors  have 
aimed  to  produce,  "a  trustworthy  guide  to 
the  application  of  electricity  in  the  practice  of 
medicine  and  Surgery." — New  York  Medical 
Times. 


In  its  perusal,  with  each  succeeding  page, 
we  have  been  more  and  more  impressed  with 
the  fact  that  here,  at  last,  we  have  a  treatise 
on  electricity  in  medicine  and  surgery  which 
amply  fulfills  its  purpose,  and  which  is  sure  of 
general  adoption  by  reason  of  its  thorough 
excellence  and  superiority  to  other  works  in- 
tended to  cover  the  same  field. — Pharmaceu- 
tical Era. 

After  carefully  looking  over  this  work,  we 
incline  to  the  beiief  that  the  intelligent  physi- 
cian who  is  familiar  with  the  general  subject 
will  be  greatly  interested  and  profited. — 
American  Lancet. 


(12) 


Medical  Publications  of  The  F.  A.  Davis  Co.,  Philadelphia. 


MASSE  Y 

Electricity  in  the  Diseases  of  Women. 

With   Special  Reference  to  the  Application  of  Strong  Currents. 

By  G.  Betton  Massey,  M.D.,  Physician  to  the  Gynaecological  Department 
of  the  Howard  Hospital  ;  late  Electro-therapeutist  to  the  Philadelphia  Orthopaedic 
Hospital  and  Infirmary  for  Nervous  Diseases,  etc.  Second  Edition.  Revised 
and  Enlarged.  With  New  and  Original  Wood-Engravings.  Handsomely  hound 
in  Dark-Blue  Cloth.  240  pages.  12mo.  No.  5  in  the  Physician*'  and  Students' 
Bendy- Reference  Series. 

This  work  is  presented  to  the  profession  as  the  most  complete  treatise  yet 
issued  on  the  electrical  treatment  of  the  diseases  of  women,  and  is  destined  to 
fill  the  increasing  demand  for  clear  and  practical  instruction  in  the  handling  and 
use  of  strong  currents  after  the  recent  methods  first  advocated  hy  Apostoli.  The 
whole  suhject  is  treated  from  the  present  stand-point  of  electric  science  with  new 
and  original  illustrations,  the  thorough  studies  of  the  author  and  his  wide  clinical 
experience  rendering  him  an  authority  upon  electricity  itself  and  its  therapeutic 
applications.  The  author  has  enhanced  the  practical  value  of  the  work  hy 
including  the  exact  details  of  treatment  and  results  in  a  number  of  cases  taken 
from  his  private  and  hospital  practice. 

Price,  post-paid,  in  the  United  States  and  Canada,  $1.50,  net;  in  Great 
Britain,  Ss.  6d. ;  in  France,  9  fr.  35. 


A  new  edition  of  this  practical  manual  at- 
tests the  utility  of  its  existence  and  the  recog- 
nition of  its  merits.  The  directions  are  simple, 
easy  to  follow  and  to  put  into  practice;  the 
ground  is  well  covered,  and  nothing  is  assumed, 
the  entire  book  being  the  record  of  expe- 
rience.—-Journal  of  Nervous  and  Menial 
Diseases. 

It  is  only  a  few  months  since  we  noticed  the 
first  edition  of  this  little  book  ;  and  it  is  only 
necessary  to  add  now  that  we  consider  it  the 


best  treatise  on  this  subject  we  have  seen,  and 
that  the  improvements  introduced  into  this 
edition  make  it  more  valuable  still. — Boston 
Medical  and  Surgical  Journ. 

The  style  is  clear,  but  condensed.  Useless 
details  are  omitted,  the  reports  of  cases  being 
pruned  of  all  irrelevant  material.  The  book 
is  an  exceedingly  valuable  one,  and  represents 
an  amount  of  study  and  experience  which  is 
only  appreciated  after  a  careful  reading. — 
Med  ical  Record . 


Physicians'  Interpreter. 

In  Four  Languages  (English,  French,  German,  and  Italian). 
Specially  Arranged  for  Diagnosis  by  M.  von  V. 

The  object  of  this  little  work  is  to  meet  a  need  often  keenly  felt  by  the 
busy,  physician,  namely,  the  need  of  some  quick  and  reliable  method  of  com- 
municating intelligibly  with  patients  of  those  nationalites  and  languages  unfa- 
miliar to  the  practitioner.  The  plan  of  the  book  is  a  systematic  arrangement  of 
questions  upon  the  various  branches  of  Practical  Medicine,  and  each  question  is 
so  worded  that  the  only  answer  required  of  the  patient  is  merely  Yes  or  No. 
The  questions  are  all  numbered,  and  a  complete  Index  renders  them  always 
available  for  quick  reference.  The  book  is  written  by  one  who  is  well  versed  in 
English,  French,  German,  and  Italian,  being  an  excellent  teacher  in  all  those 
languages,  and  who  has  also  had  considerable  hospital  experience.  Bound  in 
Full  Russia  Leather,  for  carrying  in  the  pocket.     Size,  5  x  2f  inches.     206  pages. 

Price,  post-paid,  in  the  United  States  and  Canada,  $1.00,  net;  in  Great 
Britain,  6s. ;  in  France,  6  fr.  20. 


Many  other  books  of  the  same  sort,  with 
more  extensive  vocabularies,  have  been  pub- 
lished, but,  from  their  size,  and  from  their 
being  usually  devoted  to  equivalents  in  Eng- 
lish and  one  other  language  only,  they  have 
not  had  the  advantage  which  is  pre-eminent  in 
this — convenience.  It  is  handsomely  printed, 
and  bound  in  flexible  red  leather  in  the  form 
of  a  diary.  It  would  scarcely  make  itself  felt 
in  one's  hip-pocket,  and  would  insure  its 
bearer   against   any   ordinary  conversational 


difficulty  in  dealing  with  foreign-speaking 
people,  who  are  constantly  coining  into  our 
city  hospitals. — New  York  Medical  Journal. 

This  little  volume  is  one  of.  the  most  inge- 
nious aids  to  the  physician  Vhich  we  have 
seen.  We  heartily  commend  the  book  to  any 
one  who,  being  without  a  knowledge  of  the 
foreign  languages,  fa  obliged  to  treat  those 
who  do  not  know  our  own  language. — St.  Louis 
Courier  of  Medicine. 


(13) 


Medical  Publications  of  The  F.  A.  Davis  Co.,  Philadelphia. 

The  Medical  Bulletin  Visiting-List  or 
Physicians'  Call  Record. 

arranged  upon  an  original  and  convenient  monthly  and  weekly 
Plan  for  the  Daily  Recording  of  Professional  Visits. 


Frequent  Rewriting  of  Names  Unnecessary. 

THIS  Visiting-List  is  arranged  so  that  the  names  of  patients  need  be  written 
but  once  a  month  instead  of  four  times  a  month,  as  in  the  old-style  lists. 
By  means  of  a  new  feature,  a  simple  device  consisting  of  stub  or  half 
leaves  in  the  form  of  inserts,  the  first  week's  visits  are  recorded  in  the  usual 
way,  and  the  second  week's  visits  are  begun  by  simply  turning  over  the  half-leaf 
without  the  necessity  of  rewriting  the  patients'  names.  This  very  easily  under- 
stood process  is  repeated  until  the  month  is  ended  and  the  record  has  been  kept 
complete  in  every  detail  of  visit,  charge,  credit,  etc.,  and  the  labor  and  time 
of  entering  and  transferring  names  at  least  three  times  in  the  month  has  been 
saved.  There  are  no  intricate  rulings  ;  not  the  least  amount  of  time  can  be  lost 
in  comprehending  the  plan,  for  it  is  acquired  at  a  glance. 

THE  THREE  DIFFERENT  STYLES  MADE. 

The  No.  1  Style  of  this  List  provides  space  for  the  daily  record  of  seventy 
different  names  each  month  for  a  year  ;  for  physicians  who  prefer  a  List  that  will 
accommodate  a  larger  practice  we  have  made  a  No.  2  Style,  which  provides 
space  for  the  daily  record  of  105  different  names  each  month  for  a  year,  and  for 
physicians  who  may  prefer  a  Pocket  Record-Book  of  less  thickness  than  either  of 
these  styles  we  have  made  a  No.  3  Style,  in  which  "The  Blanks  for  the  Record- 
ing of  Visits  in  "  have  been  made  into  removable  sections.  These  sections  are 
very  thin,  and  are  made  up  so  as  to  answer  in  full  the  demand  of  the  largest 
practice,  each  section  providing  ample  space  for  the  daily  record  of  210  dif- 
ferent names  for  two  months^;  or  105  different  names  daily  each  month  for  four 
months ;  or  seventy  different  names  daily  each  month  for  six  months.  Six  sets 
of  these  sections  go  with  each  copy  of  No.  3  Style. 

SPECIAL  FEATURES  NOT  FOUND  IN  ANY  OTHER  LIST. 

In  this  No.  3  Style  the  printed  matter,  and  such  matter  as  the  blank 
forms  for  Addresses  of  Patients,  Obstetric  Record,  Vaccination  Record, 
Cash  Account,  Birth  and  Death  Records,  etc.,  are  fastened  permanently  in  the 
back  of  the  book,  thus  reducing  its  thickness.  The  addition  of  one  of  these 
removable  sections  does  not  increase  the  thickness  more  than  an  eighth  of  an  inch. 
This  brings  the  book  into  such  a  small  compass  that  no  one  can  object  to  it  on 
account  of  its  thickness,  as  its  bulk  is  very  much  less  than  that  of  any  visiting- 
list  ever  published.  Every  physician  will  at  once  understand  that  as  soon  as  a 
section  is  full  it  can  be  taken  out,  filed  away,  and  another  inserted  without  the 
least  inconvenience  or  trouble.  Extra  or  additional  sections  will  be  furnished  at 
any  time  for  15  cents  each  or  $1.75  per  dozen.  This  Visiting-List  contains  calen- 
dars, valuable  miscellaneous  data,  important  tables,  and  other  useful  printed 
matter  usually  placed  in  Physicians'  Visiting-Lists. 

Physicians  of  many  years'  standing  and  with  large  practices  pronounce  it 
the  Best  List  they  have  ever  seen.  It  is  handsomely  bound  in  fine,  strong 
leather,  with  flap,  including  a  pocket  for  loose  memoranda,  etc.,  and  is  furnished 
with  a  Dixon  lead-pencil  of  excellent  quality  and  finish.  It  is  compact  and  con- 
venient for  carrying  in  the  pocket.     Size,  4  x  6£  inches. 

I1T   TriES^EE!    STYLES.  net  prices. 

No.  1.  Regular  size,  to  accommodate  70  patients  daily  each  month  for  one  year,  .  .  .  9*1.25 
No.  2.  Large  size,  to  accommodate  105  patients  daily  each  month  for  one  year,  .  .  .  .  3*1.50 
No.  3.    In  which  the  "  Blanks  for  Recording  Visits  in  "  are  in  removable  sections,  .     .     .     SI. 75 

Special  Edition  for  Great  Britain,  without  printed  matter,        4  s.  tid. 

N.  B.—The  Recording  of  Visits  in  this  List  may  be  Commenced  at  any  time  during  the  Year. 

(14.) 


Medical  Publications  of  Tlie  F.  A.  Davis  Co.,  Philadelphia. 


3IICMBNBB 

Hand-Book  of  Eclampsia; 


OR,    NOTES    AND    CASES 

OK    PVERPERAI. 

CONVULSIONS. 


By  E.  Michener,  M.D.  ;  J.  H.  Stubbs,  M.D. 
Thompson,  M.D.  ;  S.  Stebbins,  M.D.     16mo.     Cloth. 


R.  B.  Ewing,  M.D.  ;  B. 

Price,  60  cents,  net ;  in  Great  Britain,  4s.  6d. ;  France,  4  fr.  20. 


jtissbit 

A  MANUAL  OF   INSTRUCTION    FOR   GIVING 

Swedish  Movement  $  Massage  Treatment 

By  Prof.  Hartvig  Nissen,  late  Director  of  the  Swedish  Health  Institute, 
Washington,  D.  C.  ;  late  Instructor  in  Physical  Culture  and  Gymnastics  at  the 
Johns  Hopkins  University,  Baltimore,  Md. ;  Instructor  of  Swedish  and  German 
Gymnastics  at  Harvard  University's  Summer  School,  1891,  etc.,  etc. 

This  excellent  little  volume  treats  this  very  important  suhject  in  a  practical 
manner.  Full  instructions  are  given  regarding  the  mode  of  applying  the  Swedish 
Movement  and  Massage  Treatment  i  various  diseases  and  conditions  of  the 
human  system  with  the  greatest  degree  >f  effectiveness.  This  hook  is  indispens- 
able to  every  physician  who  wishes  to  A  ow  how  to  use  these  valuable  handmaids 
of  medicine. 

Illustrated  with  29  Original  Wood-Engravings.  In  one  12mo  volume  of 
128  Pages.     Neatly  bound  in  Cloth. 

Price,  post-paid,  in  the  United  States  and  Canada,  $1.00,  net;  in  Great 
Britain,  6s. ;  in  France,  6  fr.  20. 


This  manual  is  valuable  to  the  practitioner, 
as  it  contains  a  terse  description  of  a  subject 
but  too  little  understood  in  this  country.  .  . 
The  book  is  got  up  very  creditably. — N.  Y. 
Med.  Journal. 

The  present  volume  is  a  modest  account  of 
the  application  of  the  Swedish  Movement  and 
Massage  Treatment,  in  which  the  technique 


of  the  various  procedures  are  clearly  stated  as 
well  as  illustrated  in  a  very  excellent  manner. 
— North  American  Practitioner. 

This  attractive  little  book  presents  the  sub- 
ject in  a  very  practical  shape,  and  makes  it 
possible  for  every  physician  to  understand  at 
least  how  it  is  applied,  if  it  does  not  give  him 
dexterity  in  the  art  of  itsapplication. — Chicago 
Med.  Times. 


By  the  Same  Author 

A  B  C  of  the  Swedish  System  of 
Educational  Gymnastics. 

A  Practical  Hand-Book  for  School-Teachers  and  the  Home. 

By  Hartvig  Nissen. 

The  author  has  avoided  the  use  of  difficult  scientific  terms,  and  made  it 
as  popular  and  plain  as  possible. 

The  fullest  instructions  and  commands  are  given  for  each  exercise,  and 
Seventy-seven  Excellent  Engravings  illustrate  them  and  add  greatly  to  the  practical 
value  of  the  book. 

It  is  complete  in  one  neat,  small  12mo  volume  of  about  125  Pages,  and 
may  be  conveniently  carried  in  the  pocket.     Bound  in  Extra  Flexible  Cloth. 

Price,  post-paid,  in  United  States  and  Canada,  75  Cents,  net ;  in  Great 
Britain,  4s. ;  in  Trance,  I  fr. 


This  is  one  of  the  books  which  it  is  a  deliglit 
to  notice,  on  account  of  its  sterling  worth  and 
practical  utility. — Educational  Monthly,  At- 
lanta, Ga. 

We  wish  this  little  book  were  placed  in  the 
hands  of  every  teacher,  and  the  practice  of  its 
exercises  enforced  upon  every  child  of  the 
schools  of  every  State  as  well  as  in  Boston. — 
American  Lancet. 


Tlie  most  intelligent  and  complete  gymnastic 

primer  ever  published.    It  is  perfectly  simple, 

!  and  any  cliild  will  be  able  to  comprehend  it. 

'  Its  illustrations  of  the  different  movements 

;  of  the  body  explain  themselves. — The  Pacific 

Record  of  Med.  and  Surgery. 

This  small  volume  is  useful  for  physicians, 
I  students,  and  all  who  may  be  interested  in 
l  public  health.—  Med.  B ullc'tin. 


(15) 


Medical  Publications  of  The  F.  A.  Davis  Co.,  Philadelphia. 


Physician's  All-Requisite  Time-  and  Labor- 
Saving  Account-Book. 

Being  a   Ledger  and  Account-Book  for   Physicians'  Use,  Meeting 
all  the  Requirements  of  the  Law  and  Courts. 

Designed  by  William  A.  Seibert,  M.D.,  of  Easton,  Pa. 

Probably  no  class  of  people  lose  more  money  tbrough  carelessly  kept 
accounts  and  overlooked  or  neglected  bills  tban  pbysicians.  Often  detained  at 
the  bedside  of  the  sick  until  late  at  night,  or  deprived  of  even  a  modicum  of  rest, 
it  is  with  great  difficulty  that  he  spares  the  time  or  puts  himself  in  condition  to 
give  the  same  care  to  his  own  financial  interests  that  a  merchant,  a  lawyer,  or 
even  a  farmer  devotes.  It  is  then  plainly  apparent  that  a  system  of  bookkeeping 
and  accounts  that,  without  sacrificing  accuracy,  but,  on  the  other  hand,  ensuring 
it,  at  the  same  time  relieves  the  keeping  of  a  physician's  book  of  half  their 
complexity  and  two-thirds  the  labor,  is  a  convenience  which  will  be  eagerly 
welcomed  by  thousands  of  overworked  physicians.  Such  a  system  has  at  last 
been  devised,  and  we  take  pleasure  in  offering  it  to  the  profession  in  the  form  ot 
The  Physician's  All -Requisite  Time-  and  Labor-  Saving  Account-Book. 

There  is  no  exaggeration  in  stating  that  this  Account-Book  and  Ledger 
reduces  the  labor  of  keeping  your  accounts  more  than  one -half,  and  at  the  same 
time  secures  the  greatest  degree  of  accuracy.  We  may  mention  a  few  of  the 
superior  advantages  of  The  Physician's  All-Requisite  Time-  and  Labor-  Saving 
Account-Book,  as  follows  : — 


First — Will  meet  all  the  requirements 
of  the  law  and  courts. 

Second — Self-explanatory  ;  no  cipher 
code. 

Third — Its  completeness  without  sacri- 
ficing anything. 

Fourth — No  posting  ;  one  entry  only. 

Fifth — Universal ;  can  be  commenced  at 
any  time  of  the  year,  and  can  be 
continued  indefinitely  until  every 
account  is  filled. 

Sixth — Absolutely  no  waste  of  space. 

Seventh — One  person  must  needs  be 
sick  every  day  of  the  year  to  fill 
his  account,  or  might  be  ten  years 
about  it  and  require  no  more  than 
the  space  for  one  account  in  this 
ledger. 

Eighth — Double  the  number  and  many 
times  more  than  the  number  of  ac- 


counts in  any  similar  book  ;  the 
300-page  book  contains  space  for 
900  accounts,  and  the  600-page 
book  contains  space  for  1800  ac- 
counts. 

Ninth — There  are  no  smaller  spaces. 

Tenth — Compact  without  sacrificing 
completeness  ;  every  account  com- 
plete on  same  page — a  decided  ad- 
vantage and  recommendation. 

Eleventh — Uniform  size  of  leaves. 

Twelfth — The  statement  of  the  most 
complicated  account  is  at  once  be- 
fore you  at  any  time  of  month  or 
year — in  other  words,  the  account 
itself  as  it  stands  is  its  simplest 
statement. 

Thirteenth — No  transferring  of  accounts, 
balances,  etc. 


To  all  physicians  desiring  a  quick,  accurate,  and  comprehensive  method  of 
keeping  their  accounts,  we  can  safely  say  that  no  book  as  suitable  as  this  one  has 
ever  been  devised.  A  descriptive  circular  showing  the  plan  of  the  book  will  be 
sent  on  application. 

NET  PRICES,  SHIPPING  EXPENSES  PREPAID. 

No.  1.  300  Pages,  for  900  Accounts  per  Year, 

Size  10x12,  Bound  in  K -Russia,  Raised 

Back  Bands,  Cloth  Sides, 
No.  2.  600  Pages,  for  1800  Accounts  per  Tear, 

Size  10x12,  Bound  in  # -Russia,  Baised 

Back-Bands,  Cloth  Sides, 

(16) 


Canada 

Great 

In  IT.  S. 

(dutv  paid). 

Britain. 

France. 

$5.00 

$5.50 

28s. 

30  ft.  30. 

8.00 


8.80 


42s. 


49  fr.  40 


Medical  Publications  of  The  F.  A.  Davis  Co.,  Philadelphia. 


PRICE  and  EAGLETON 

Three  Charts  of  the  Nervo-Vascular  System. 

Part  I. — The  Nerves.      Part  II. — The  Arteries. 
Part  III. — The  Veins. 

A  New  Edition,  Revised  and  Perfected.  Arranged  by  "W.  Henry  Prick, 
M.D.,  and  S.  Potts  Eagleton,  M.D.  Endorsed  by  leading  anatomists.  Clearly 
ana  beautifully  printed  upon  extra  durable  paper. 

PART  I.  The  Nerves. — Gives  in  a  clear  form  not  only  the  Cranial  and  Spinal  Nerves,  show- 
ing the  formation  of  the  different  Plexuses  and  their  branches,  but  ajfco  the  complete 
distribution  of  (he  Sympathetic  Nerves. 

PART  II.  The  Arteries — Gives  a  unique  grouping  of  the  Arterial  system,  showing  the 
divisions  and  subdivisions  of  all  the  vessels,  beginning  from  the  heart  and  tracing  their 
CONTINUOUS  distribution  to  the  periphery,  and  showing  at  a  glance  the  terminal 
branches  of  each  artery. 

PART  III.  The  Veins— Shows  how  the  blood  from  the  periphery  of  the  body  is  gradually 
collected  by  the  larger  veins,  and  these  coalescing  forming  still  larger  vessels,  until  they 
finally  trace  themselves  into  the  Right  Auricle  of  the  heart. 

It  is  therefore  readily  seen  that  "The  Nervo-Vascular  System  of  Charts  " 
offers  the  following  superior  advantages  : — 

1.  It  is  the  only  arrangement  which  combines  the  Three  Systems,  and  yet 
each  is  perfect  and  distinct  in  itself. 

2.  It  is  the  only  instance  of  the  Cranial,  Spinal,  and  Sympathetic  Nervous 
Systems  being  represented  on  one  chart. 

3.  From  its  neat  size  and  clear  type,  and  being  printed  only  upon  one  side, 
it  may  be  tacked  up  in  any  convenient  place,  and  is  always  ready  for  freshening 
up  the  memory  and  reviewing  for  examination. 

Price,  post-paid,  in  United  States  and  Canada,  50  cents,  net,  complete ;  in 
Great  Britain,  3s.  61 ;  in  France,  3  fr.  60. 


For  the  student  of  anatomy  there  can  pos- 
sibly be  no  more  concise  way  of  acquiring  a 
knowledge  of  the  nerves,  veins,  and  arteries 
of  the  human  system.  It  presents  at  a  glance 
their  trunks  and  branches  in  the  great  divis- 
ions of  the  body.  It  will  save  a  world  of  tedi- 
ous reading,  and  will  impress  itself  on  the 
mind  as  no  ordinary  vade  mecum,  even,  could. 


Its  price  is  nominal  and  its  value  inestimable. 
No  student  should  be  without  it. — Pacific 
Record  of  Medicine  and  Surgery. 

These  are  three  admirably  arranged  charts 
for  the  use  of  students,  to  assist  in  memor- 
izing their  anatomical  sudies. — Buffalo  Med. 
and  Surg.  Jour. 


JPUBDY 

Diabetes:  Its  Cause,  Symptoms  $  Treatment 

By  Chas.  W.  Purdt,  M.D.  (Queen's  University),  Honorary  Fellow  of  t lie 
Royal  College  of  Physicians  and  Surgeons  of  Kingston  ;  Member  of  the  College 
of  Physicians  and  Surgeons  of  Ontario  ;  Author  of  "Blight's  Disease  and  Allied 
Affections  of  the  Kidneys  ;"  Member  of  the  Association  of  American  Physicians  ; 
Member  of  the  American  Medical  Association  ;  Member  of  the  Chicago  Academy 
of  Sciences,  etc. 

Contf.nts. — Section  I.  Historical,  Geographical,  and  Climatological  Con- 
siderations of  Diabetes  Mellitus.  II.  Physiological  and  Pathological  Considera- 
tions of  Diabetes  Mellitus  III.  Etiology  of  Diabetes  Mellitus.  IV.  Morbid 
nnaiomy  of  Diabetes  Mellitus.  V.  Symptomatology  of  Diabetes  Mellitus.  VI. 
Treatment  of  Diabetes  Mellitus.  VII.  Clinical  Illustrations  of  Diabetes  Mellitus. 
VIII.  Diabetes  Insipidus  ;  Bibliography. 

12mo.  Dark  Blue  Extra  Cloth.  Nearly  200  pages.  With  Clinical  Illus- 
trations.    N~o.  S  in  the  Physicians'  and  Students'  Ready -Reference  Series. 

Price,  post-paid,  in  the  United  States  and  Canada,  $1.25,  net;  in  Great 
Britain,  6s.  6i ;  in  Prance,  7  fr.  75. 

This  will  prove  a  most  entertaining  as  well 
as  most  interesting  treatise  upon  a  disease 
which  frequently  falls  to  the  lot  of  every 
practitioner.  The  work  has  been  written  with 
a  special  view  of  bringing  out  the  features  of 
the  disease  as  it  occurs  in  the  United  States. 
The  author  has  very  judiciously  arranged  the 
little  volume,  and  it  will  offer  many  pleasant 
attractions  to  the  practitioner. — Nashville 
Journal  of  Medicine  and  Surgery. 

While  many  monographs  have  been  pub- 


lished which  have  dealt  with  the  subject  of 
diabetes,  we  know  of  none  which  so  thoroughly 
considers  its  relations  to  the  geographical 
conditions  which  exist  in  the  United  States, 
nor  which  is  more  complete  in  its  summary  of 
the  symptomatology  and  treatment  of  this 
affection.  A  number  of  tables,  showing  the 
percentage  of  sugar  in  a  very  large  number  of 
alcoholic  heverages,  adds  very  eonsiderahly  to 
the  value  of  the  work. — Medical  News. 


(17) 


Medical  Publications  of  The  F.  A.  Davis  Co.,  Philadelphia. 


MJEMONDINO 

History  of  Circumcision. 

From  the  Earliest  Times  to  the  Present.     Moral  and  Physical 
Reasons  for  its  Performance  ;  with  a  History  of  Eunuchism, 
Hermaphrodism,  etc.,  and  of  the  Different  Opera- 
tions Practiced  upon  the  Prepuce. 
By  P.  C.  Remondino.  M.D.  (Jefferson),  Member  of  the  American  Med- 
ical Association  ;   of  the  American   Public  Health  Association  ;    Vice- 
President  of  California  State  Medical  Society  and  of  Southern  California 
Medical  Society,  etc. 

In  one  neat  12mo  volume  of  346  pages.  Handsomely  bound  in  Extra 
Dark-Blue  Cloth,  and  illustrated  with  two  fine  wood-engravings,  showing 
the  two  principal  modes  of  Circumcision  in  ancient  times.  No.  11  in  the 
Physicians1  and  Students1  Ready-Reference  Series. 

Price,  post-paid,  in  United  States  and  Canada,  $1.25,  net;  in  Great  Britain, 

6s.  6d. ;  in  France,  7  fr.  75. 
A  Popular  Edition  (unabridged),  bound  in  Paper  Covers,  is  also  issued.   Price, 

50  Cents,  net ;  in  Great  Britain,  3s. ;  in  France,  3  fr.  60. 

Every  physician  should  read  this  book;  he  will  there  find,  in  a 
condensed  and  S3'stematized  form,  what  there  is  known  concerning 
Circumcision.  The  book  deals  with  simple  facts,  and  it  is  not  a  disserta- 
tion on  theories.  It  deals,  in  plain,  pointed  language,  with  the  relation 
that  the  prepuce  bears  to  physical  degeneracy  and  disease,  bases  all  its 
utterances  on  what  has  occurred  and  on  what  is  known.  The  author  has 
here  gathered  from  every  source  the  material  for  his  subject,  and  the 
deductions  are  unmistakable. 


This  is  a  very  full  and  readable  book.  To 
the  reader  who  wishes  to  know  all  about 
the  antiquity  of  the  operation,  with  the  views 
pro  and  con  of  the  right  of  this  appendage  to 
exist,  its  advantages,  dangers,  etc.,  this  is  the 
book. — The  Southern  Clinic. 

The  operative  chapter  will  be  particu- 
larly useful  and  interesting  to  physicians,  as 
it  contains  a  careful  and  impartial"  review  of 
all  the  operative  procedures,  from  the  most 


simple  to  the  most  elaborate,  paying  particular 
attention  to  the  subject  of  after-dressings  It 
is  a  very  interesting  and  instructive  work,  and 
should  be  read  very  liberally  by  the  profes- 
sion.— The  Med.  Brief. 

The  author's  views  in  regard  to  circum- 
cision, its  necessity,  and  its  results,  are  well 
founded,  and  its  performance  as  a  prophylactic 
measure  is  well  established. — Columbus  Med. 
Journal. 


By  the  Same  Author 

The  Mediterranean  Shores  of  America. 

Southern  California:  Its  Climatic,  Physical,  and  Meteorological 

Conditions. 
By  P.  0.  Remondino,  M.D.  (Jefferson),  etc. 

Complete  in  one  handsomely  printed  Octavo  volume  of  nearly  175 
pages,  with  45  appropriate  illustrations  and  2  finely  executed  maps  of 
the  region,  showing  altitudes,  ocean  currents,  etc.    Bound  in  Extra  Cloth. 

Price,  post-paid,  in  United  States  and  Canada,  $1.25,  net;  in  Great  Britain, 

6s.  6d. ;  in  Prance,  7  fr.  75. 
Cheaper  Edition  (unabridged),  bound  in  Paper,  post-paid,  in  United  States  and 

Canada,  75  Cents,  net ;  in  Great  Britain,  is. ;  in  Prance,  5  fr. 

Italy,  of  the  Old  World,  does  not  excel  nor  even  approach  this  region 
in  point  of  salubrity  of  climate  and  all-around  healthfulness  of  environ- 
ment. This  book  fully  describes  and  discusses  this  wonderfully  charming 
country.  The  medical  profession,  who  have  long  desired  a  trustworthy 
treatise  of  true  scientific  value  on  this  celebrated  region,  will  find  in  this 
volume  a  satisfactory  response  to  this  long-felt  and  oft-expressed  wish. 

(18)  & 


Medical  Publications  of  The  F.  A.  Dams  Co.,  Phiiaaetp/na. 


MOITE 

Text-Book  of  Hygiene. 

A   Comprehensive  Treatise  on  the  Principles  and  Practice  of 
Preventive  Medicine  from  an  American  Stand-point. 

By  George  H.  Rohe,  M.D.,  Professor  of  Obstetrics  and  Hygiene  in 
the  College  of  Physicians  and  Surgeons,  Baltimore;  Member  of  the 
American  Public  Health  Association,  etc. 

Every  Sanitarian  should  have  Robe's  ,"  Text-Book  of  Hygiene  "  as  a 
work  of  reference. 

Second  Edition,  thoroughly  revised  and  largely  rewritten,  with 
many  illustrations  and  valuable  tables.  In  one  handsome  Royal  Octavo 
volume  of  over  400  pages,  bound  in  Extra  Cloth. 

Price,  post-paid,  in  United  States,  $2.50,  net ;  Canada  (duty  paid),  $2.75, 
net ;  Great  Britain,  lis. ;  France,  16  fr.  20. 

improvement  over  the  first,  all  of  the  matter 
being  thoroughly  revised,  much  of  it  being 
rewritten,  ana  many  additions  being  made. 
The  size  of  the  book  is  increased  one  hundred 
pages.  The  book  has  the  original  recommenda- 
tion of  being  a  handsomely-bound,  clearly- 
printed  octavo  volume,  profusely  illustrated 
with  reliable  references  for  every  branch  of 
the  subject  matter. — Medical  Record 


One  prominent  feature  is  that  there  are  no 
superfluous  words  ;  every  sentence  is  direct 
to  the  point  sought.  It  is,  therefore,  easy 
reading,  and  conveys  very  much  information 
in  little  space. — The  Pacific  Record  of  Medi- 
cine and  Surgery. 

It  is  unquestionably  a  work  that  should  be 
in  the  hands  of  every  physician  in  the  country, 
and  medical  students  will  find  it  a  most  excel- 
lent and  valuable  text-book. — 27»e  Southern 
Practitioner. 

The  first  edition  was  rapidly  exhausted,  and 
the  book  justly  became  an  authority  to  physi- 
cians and  sanitary  officers,  and  a  text-book 
very  generally  adopted  in  the  colleges  through- 
out America.     The  second  edition  is  a  great 


The  wonder  is  how  Professor  Rohe  has  made 
the  book  so  readable  and  entertaining  with  so 
much    matter   necessarily  condensed.     Alto- 

E ether,  the  manual  is  a  good  exponent  of 
ygiene  and  sanitary  science  from  the  present 
American  stand-point,  and  will  repay  with 
pleasure  and  profit  any  time  that  may  be  given 
to  its  perusal. — University  Medical  Magazine. 


By  the  Same  Author 

A  Practical  Manual  of  Diseases 
of  the  Skin. 

By  George  H.  Roue,  M.D.,  Professor  of  Materia  Medica,  Thera- 
peutics, and  Hygiene,  and  formerly  Professor  of  Dermatology  in  the 
College  of  Physicians  and  Surgeons,  Baltimore,  etc.,  assisted  by  J. 
Williams  Lord,  A.B.,  M.D.,  Lecturer  on  Dermatology  and  Bandaging 
in  the  College  of  Physicians  and  Surgeons;  Assistant  Physician  to  the 
Skin  Department  in  the  Dispensary  of  Johns  Hopkins  Hospital. 

In  one  neat  12mo  volume  of  over  300  pages,  bound  in  Extra  Dark-Blue 
Cloth.      No.  13  in  the  Physicians1  and  Students1  Beady- Reference  Series. 

Price,  post-paid,  in  the  United  States  and  Canada,  $1.25,  net;  in  Great 
Britain,  6s.  6d. ;  in  France,  7  fr.  75. 

The  practical  character  of  this  work  makes  it  specially  desirable 
for  the  use  of  students  and  general  practitioners. 

The  nearly  one  hundred  (100)  reliable  and  carefully  prepared  For- 
mulae at  the  end  of  the  volume  add  not  a  little  to  its  practical  value. 

All  the  various  forms  of  skin  diseases,  from  Acne  to  Zoster  (alpha- 
betically speaking),  are  succinctly  yet  amply  treated  of, 'and  the  arrange- 
ment of  the  book,  with  its  excellent  index  and  unusually  full  table  of 
contents,  goes  to  make  up  a  truly  satisfactory  volume  for  ready  reference 
in  daily  practice. 

(19) 


Medical  Publications  of  The  F.  A.  Davis  Co.,  Philadelphia. 


&K20T 

Principles  of  Surgery. 

By  N.  Senn,  M.D.,  Ph.D.,  Professor  of  Practice  of  Surgery  and  Clinical  Surgery  in 
Rush  Medical  College,  Chicago,  111. ;  Professor  of  Surgery  in  the  Chicago  Polyclinic ;  At- 
tending Surgeon  to  the  Milwaukee  Hospital ;  Consulting  Surgeon  to  the  Milwaukee  County 
Hospital  and  to  the  Milwaukee  County  Insane  Asylum. 

This  work,  by  one  of  America's  greatest  surgeons,  is  thoroughly  complete  ;  its 
clearness  and  brevity  of  statement  are  among  its  conspicuous  merits.  The  author's  long, 
able,  and  conscientious  researches  in  every  direction  in  this  important  field  are  a  guarantee, 
of  unusual  trustworthiness,  that  every  branch  of  the  subject  is  treated  authoritatively,  and  in 
such  a  manner  as  to  bring  the  greatest  gain  in  knowledge  to  the  practitioner  and  student. 

In  one  handsome  Royal  Octavo  volume,  with  109  fine  Wood-Engravings  and  624 
pages. 

United  States.    Canada  (duty  paid).    Great  Britain.  France 

Price  in  Cloth,  $4.50,  Net        $5.00,  Net         24s.  6i        27  fr.  20 

"        Sheep  or  ^-Russia,       5.50    "  6.10    "  30s.  33  fr.  10 


Stephen  Smith,  M.D.,  Professor  of  Clin- 
ical Surgery  Medical  Department  University 
of  the  City  of  New  York,  writes : — "  I  have 
examined  the  work  with  great  satisfaction, 
and  regard  it  as  a  most  valuable  addition  to 
American  surgical  literature.  There  has  long 
been  great  need  of  a  work  on  the  principles  of 
surgery  which  would  fully  illustrate  the  pres- 
ent advanced  state  of  knowledge  of  the  various 
subjects  embraced  in  this  volume.  The  work 
seems  to  me  to  meet  this  want  admirably." 

Lewis  A.  Sayre,  M.D.,  Professor  Ortho- 
paedic Surgerv  Bellevue  Hospital  Medical 
College,  New  Vork,  writes : — "  My  Dear  Doctor 
Senn  :  Your  very  valuable  work  on  surgery, 
sent  to  me  some  time  since,  I  have  studied 
with  great  satisfaction  and  improvement.  I 
congratulate  you  most  heartily  on  having  pro- 
duced the  most  classical  and  practical  work  on 
surgery  yet  published." 

Frank  J.  Lptz,  M.D.,  St.  Louis,  Mo.,  says  : 
— "It  seems  incredible  that  those  who  pretend 
to  teach  have  done  without  such  a  guide 
before,  and  I  do  not  understand  how  our  stu- 
dents succeeded  in  mastering  the  principles  of 
modern  surgery  by  attempting  to  read  our 
obsolete  text-books.  American  surgery  should 
feel  proud  of  the  production,  and  the  present 
generation  of  surgeons  owe  you  a  debt  of 
gratitude." 

Wm.  Oseer,  M.D.,  The  Johns  Hopkins  Hos- 
pital, Baltimore,  says: — "You  certainly  have 
covered  the  ground  thoroughly  and  well,  and 
with  a  thoroughness  I  do  not  know  of  in  any 
similar  work.  I  should  think  it  would  prove 
a  great  boon  to  the  students  and  also  to  very 
many  teachers." 

The  work  is  systematic  and  compact,  without 
a  fact  omitted  "or  a  sentence  too  much,  and  it 
not  only  makes  instructive  but  fascinating 
reading.  A  conspicuous  merit  of  Senn's  work 
is  his  method,  his  persistent  and  tireless  search 
through  original  investigations  for  additions 


to  knowledge,  and  the  practical  character  of 
his  discoveries. — The  Review  of  Insanity  and 
JVervous  Diseases. 

Every  chapter  is  a  mine  of  information  con- 
taining all  the  recent  advances  on  the  subjects 
presented  in  such  a  systematic,  instructive, 
and  entertaining  style  that  the  reader  will  not 
willingly  lay  it  aside,  but  will  read  and  re-read 
with  pleasure  and  profit. — Kansas  Medical 
Journal. 

After  perusing  this  work  on  several  different 
occasions,  we  have  come  to  the  conclusion  that 
it  is  a  remarkable  work,  by  a  man  of  unusual 
ability.  The  author  seems  to  have  had  a  very 
large  personal  experience,  which  is  freely  made 
use  of  in  the  text,  besides  which  he  is  familiar 
with  almost  all  that  has  been  written  in  Eng- 
lish and  German  on  the  above  topics. — JVie 
Canada  Medical  Record. 

The  work  is  exceedingly  practical,  as  the 
chapters  on  the  treatment  of  the  various  con- 
ditions considered  are  based  on  sound  deduc- 
tions, are  complete,  and  easily  carried  out  by 
any  painstaking  surgeon.  All  in  all,  the  book 
is  a  most  excellent  one,  and  deserves  a  place  in 
every  well-selected  library. — Medical  Record. 

It  will  prove  exceedingly  valuable  in  the 
diffusion  of  more  thorough  knowledge  of  the 
subject-matter  among  English-speaking  sur- 

feons.  As  in  the  case  of  all  his  work,  he  has 
one  this  in  a  truly  admirable  manner.  The 
book  throughout  is  worthy  of  the  highest 
praise.  It  should  be  adopted  as  a  text-book 
in  all  of  our  schools. —  University  Medical 
Magazine. 

The  principles  of  surgery,  as  expounded  by 
Dr.  Senn,  are  such  as  to  place  the  student  in 
the  independent  position  of  evolving  from 
them  methods  of  treatment ;  the  master  of  tbe 
principles  readily  becomes  equally  a  master 
of  practice.  And  this,  of  course,  is  really  the 
whole  purpose  of  the  volume. —  Weekly  Med- 
ical Review. 


HAY  FEWER 


S  A  JO  US 

And  Its  Successful  Treatment  toy  Superficial 

Organic  Alteration  of  tlie  Nasal 

mucous  Membrane. 

By  Cn.\RLES  E.  Sajous,  M.D.,  formerly  Lecturer  on  Rhinology  and  Laryngology  in 
Jefferson  Medical  College  ;  Cnief  Editor  of  the  Annual  of  the  Universal  Medical  Sciences, 
etc     With  13  Engravings  on  Wood.     103  pages.     12mo.     Bound  in  Cloth,  Beveled  Edges. 

Price,  post-paid,  in  the  United  States  and  Canada,  $1.00,  net;  in  Great 
Britain,  6s. ;  in  France,  6  fr.  20. 

(20) 


Medical  Publications  of  The  F.  A.  Davis  Co.,  Philadelphia. 


SHOEMAKER 

Heredity,  Health,  and  Personal  Beauty. 

Including  the  Selection  of  the  Best  Cosmetics  for  the  Skin,  Hatr, 

Nails,  and  all  Parts  Relating  to  the  Body. 

By  John  V.  Shoemaker,  A.M.,  M.D.,  Professor  of  Materia  Medica,  Phar- 
macology, Therapeutics,  and  Clinical  Medicine,  and  Clinical  Professor  of  Diseases 
of  the  Skin  in  the  Medico-Chirurgical  College  of  Philadelphia;  Physician  to  the 
Medico-Chirurgical  Hospital,  etc.,  etc. 

The  health  of  the  skin  and  hair,  and  how  to  promote  them,  are  discussed; 
the  treatment  of  the  nails;  the  subjects  of  ventilation,  food,  clothing,  warmth, 
bathing;  the  circulation  or  the  blood,  digestion,  ventilation;  in  fact,  all  that  in 
daily  life  conduces  to  the  well-being  of  the  body  and  refinement  is  duly  enlarged 
upon.  To  these  stores  of  popular  information  is  added  a  list  of  the  best  medicated 
soaps  and  toilet  soaps,  and  a  whole  chapter  of  the  work  is  devoted  to  household 
remedies.  The  work  is  largely  suggestive,  and  gives  wise  and  timely  advice  as 
to  when  a  physician  should  be  consulted.  This  is  just  the  book  to  place  on  the 
waiting-room  table  of  every  physician,  and  a  work  that  will  prove  useful  in  the  hands 
of  your  patients. 

Complete  in  one  handsome  Royal  Octavo  volume  of  425  pages,  beautifully 
and  clearly  printed,  and  bound  in  Extra  Cloth,  Beveled  Edges,  with  side  and 
back  gilt  stamps  and  in  Half-Morocco  Gilt  Top. 

Price,  in  United  States,  post-paid,  Cloth,  $2.50;  Half-Morocco,  $3.50, 
net.  Canada  (duty  paid),  Cloth,  $2.75;  Half-Morocco,  $3.90,  net. 
Great  Britain,  Cloth,  14s. ;  Half-Morocco,  19s.  6d.  France,  Cloth, 
15  fr.;  Half-Morocco,  22  fr. 


The  book  reads  not  like  the  fulfillment  of  a 
task,  but  like  the  researches  and  observations 
of  one  thoroughly  in  love  with  his  subject, 
fully  appreciating  its  importance,  and  writing 
for  the  pleasure  he  experiences  in  it.  The 
work  is  verv  comprehensive  and  complete  in 
its  scape.— Medical  World. 

The  book  before  us  is  a  most  remarkable 

Eroduction  and  a  most  entertaining  one.  The 
ook  is  equally  well  adapted  for  the  laity  or 
the  profession.  It  tells  us  how  to  be  healthy, 
happy,  and  as  beautiful  as  possible.  We  can't 
review  this  book  ;  it  is  different  from  anything 
we  have  ever  read.  It  runs  like  a  novel,  and 
will  be  perused  until  finished  with  pleasure 
and  profit.    Buy  it,  read  it,  and  be  surprised, 


pleased,  and  improved. — The  Southern  Clinic 
This  book  is  written  primarily  for  the  laity, 
but  will  prove  of  interest  to  the  physician  as 
well.  Though  the  author  goes  to  some  extent 
into  technicalities,  he  confines  himself  to  the 
use  of  good,  plain  English,  and  in  that  respect 
sets  a  notable  example  to  many  other  writers 
on  similar  subjects.  Furthermore,  the  book 
is  written  from  a  thoroughly  American  stand- 
point.— Medical  Record. 

This  is  an  exceedingly  interesting  book, 
both  scientific  and  practical  in  character,  in- 
tended for  both  professional  and  lay  readers. 
The  book  is  well  written  and  presented  in  ad- 
mirable form  by  the  publisher.— Canadian 
Practitioner. 


SHOEMAKER 


Ointments  and  Oleates : 


Especially    In    Diseases 
of  the  Skin. 

By  John  V.  Shoemaker,  A.M.,  M.D.,  Professor  of  Materia  Medica,  Phar- 
macology, Therapeutics,  and  Clinical  Medicine,  and  Clinical  Professor  of  Diseases 
of  the  Skin  in  the  Medico-Chirurgical  College  of  Philadelphia,  etc.,  etc. 

The  author  concisely  concludes  his  preface  as  follows  :  "The  reader  may 
thus  obtain  a  conspectus  of  the  whole  subject  of  inunction  as  it  exists  to-day  in 
the  civilized  world.  In  all  cases  the  mode  of  preparation  is  given,  and  the  thera- 
peutical application  described  seriatim,  in  so  far  as  may  be  done  without  needless 
repetition." 

Second  Edition,  revised  and  enlarged.  298  pages.  12mo.  Neatly  bound 
in  Dark-Blue  Cloth.    No.  6  in  the  Physicians'  and  Students'  Ready-Reference  Series. 

Price,  post-paid,  in  the  United  States  and  Canada,  $1.50,  net;  in  Great 
Britain,  8s.  6d. ;  in  Trance,  9  fr.  35. 


It  is  invaluable  as  a  ready  reference  when 
ointments  or  oleates  are  to  be  used,  and  is 
serviceable  to  both  druggist  and  physician.— 
Canada  Medical  Record. 

To  the  physician  who  feels  uncertain  as  to 


the  best  form  in  which  to  prescribe  medicines 
bv  way  of  the  skin  the  book  will  prove  valu- 
able, owing  to  the  many  prescriptions  and 
formulae  which  dot  its  pages,  while  the  copious 
index  at  the  back  materially  aids  in  making 
the  book  a  useful  one.— Medical  News. 


(21) 


Medical  Publications  of  The  F.  A.  Davis  Co.,  Philadelphia. 
SHOEMAKER 

Materia  Medica  and  Therapeutics. 

With  Especial  Reference  to  the  Clinical  Application  of  Drugs. 
Being  the  Second  and  Last  Volume  of  a  Treatise  on  Materia 
Medica,  Pharmacology,  and  Therapeutics,  and  an  Independent 
Volume  upon  Drugs. 

By  John  V.  Shoemaker,  A.M.,  M.D.,  Professor  of  Materia  Medica, 
Pharmacology,  Therapeutics,  and  Clinical  Medicine,  and  Clinical  Professor  of 
Diseases  of  the  Skin  in  the  Medico-Chirurgical  College  of  Philadelphia;  Physician 
to  the  Medico-Chirurgical  Hospital,  etc.,  etc. 

This,  the  second  volume  of  Shoemaker's  "Materia  Medica,  Pharmacology, 
and  Therapeutics,"  is  wholly  taken  up  with  the  consideration  of  drugs,  each 
remedy  being  studied  from  three  points  of  view,  viz. :  the  Preparations,  or  Materia 
Medica;  the  Physiology  and  Toxicology,  or  Pharmacology;  and,  lastly,  its 
Therapy.  It  is  thoroughly  abreast  of  the  progress  of  Therapeutic  Science,  and 
is  really  an  indispensable  book  to  every  student  and  practitioner  of  medicine. 

Royal  Octavo,  about  675  pages.     Thoroughly  and  carefully  indexed. 

Price,  in  United  States,  post-paid,  Cloth,  $3.50;  Sheep,  $4.50,  net. 
Canada  (duty  paid),  Cloth,  $1.00;  Sheep,  $5.00,  net.  Great  Brit- 
ain, Cloth,  20s. ;  Sheep,  26s.  France,  Cloth,  22  fr.  40;  Sheep, 
28  fr.  60. 

The  first  volume  of  this  work  is  devoted  to  Pharmacy,  General  Pharma- 
cology, and  Therapeutics,  and  remedial  agents  not  properly  classed  with  drugs. 
Royal  Octavo,  353  pages. 

Price  of  Volume  I,  post-paid,  in  United  States,  Cloth,  $2.50,  net;i  Sheep, 
$3.25,  net.  Canada,  duty  paid,  Cloth,  $2.75,  net;  Sheep,  $3.60,  net. 
Great  Britain,  Cloth,  14s. ;  Sheep,  18s.  France,  Cloth,  16  fr.  HO ; 
Sheep,  20  fr.  20.    The  volumes  are  sold  separately. 

SHOEMAKER'S  TREATISE  ON  MATERIA  MEDICA,  PHARMACOLOGY,  AND  THERA- 
PEUTICS STANDS  ALONE. 

(1)  Among  Materia  Medica  text-books,  in  that  it  includes  every  officinal  drug  and  every 

preparation  contained  in  the  United  States  Pharmacopoeia. 

(2)  In  that  it  is  the  only  work  on  therapeutics  giving  the  strength,  composition,  and  dosage 

of  every  officinal  preparation. 

(3)  In  giving  the  latest  investigations  with  regard  to  the  physiological  action  of  drugs  and 

the  most  recent  applications  in  therapeutics. 

(4)  In  combining  with  officinal  drugs  the  most  reliable  reports  of  the  actions  and  uses  of  all 

the  noteworthy  new  remedies,  such  as  acetanilid,  antipyrin,  bromoform,  exalgin,  pyok- 
tanin,  pyridin,  somnal, spermine  (Brown-Sequard),  tuberculin  (Koch's lymph), sulphonal, 
thiol,  urethan,  etc.,  etc. 

(5)  As  a  complete  encyclopaedia  of  mortem  therapeutics  in  condensed  form,  arranged  alpha- 

betically for  convenience  of  reference  for  either  physician,  dentist,  or  pharmacist,  when 
immediate  information  is  wanted  concerning  the  action,  composition,  dose,  or  antidotes 
for  any  officinal  preparation  or  new  remedy. 

(6)  In  giving  the  physical  characters  and  chemical  formulae  of  the  new  remedies,  especially 

the  recently-introduced  antipyretics  and  analgesics. 

(7)  In  the  fact  that  it  gives  special  attention  to  the  consideration  of  the  diagnosis  and  treat- 

ment of  poisoning  by  the  more  active  drugs,  both  officinal  and  non-officinal. 

(8)  And  unrivaled  in  the  number  and  variety  of  the  prescriptions  and  practical  formulae, 

representing  the  latest  achievements  of  clinical  medicine. 

(9)  In  that,  while  summarizing  foreign  therapeutical  literature,  it  fully  recognizes  the  work 

done  in  this  department l>y  American  physicians.  It  is  an  epitome  of  the  present  state 
of  American  medical  practice,  which  is  universally  acknowledged  to  be  the  best  practice. 
(tO)  Because  it  is  the  most  complete,  convenient,  and  compendious  work  of  reference,  being, 
in  fact,  a  companion  to  the  United  States  Pharmacopoeia,  a  drug-encyclopaedia,  and  a 
therapeutic  hand-book  all  in  one  volume. 


The  value  of  the  book  lies  in  the  fact  that 
it  contains  all  that  is  authentic  and  trust- 
worthy about  the  host  of  new  remedies  which 
have  deluged  us  in  the  last  five  years.  The 
paces  are  remarkably  free  from  useless  infor- 
mation. The  author  has  done  well  in  following 
the  alphabetical  order. — N.  Y.  Med.  Record. 

In  perusing  the  pages  devoted  to  the  special 
consideration  of  drug*,  their  pharmacology, 
physiological  action,  toxic  action,  and  therapy, 
one  is  constantly  surprised  at  the  amount  or 


material  compressed  in  so  limited  a  space. 
The  book  will  prove  a  valuable  addition  to  the 
physician  's  library. — Occidental  Med.  Times. 
It  is  a  meritorious  work,  with  many  unique 
features.  It  is  richly  illustrated  by  well-tried 
prescriptions  showing  the  practical  applica- 
tion of  the  various  drugs  discussed.  In  short, 
this  work  makes  a  pretty  complete  encyclo- 
paedia of  the  science  of  therapeutics,  conve- 
niently arranged  for  handy  reference. — Med. 
Wwld. 


(22) 


Medical  Publications  of  Tlie  F.  A.  Davis  Co.,  Philadelphia. 
SMITH 

Physiology  of  the  Domestic  Animals. 

A  Text-Book  for  Veterinary  and  Medical  Students  and  Practitioners. 

By  Robert  Meade  Smith,  A.M.,  M.D  ,  Professor  of  Comparative  Physi- 
ology in  University  of  Pennsylvania;  Fellow  of  the  College  of  Physicians  and 
Academy  of  the  Natural  Sciences,  Philadelphia;  of  American  Physiological 
Society;  of  the  American  Society  of  Naturalists,  etc. 

This  new  and  important  work,  the  most  thoroughly  complete  in  the 
English  language  on  this  subject,  treats  of  the  physiology  of  the  domestic  animals 
in  a  most  comprehensive  manner,  especial  prominence  being  given  to  the  subject 
of  toods  and  fodders,  and  the  character  of  the  diet  for  the  herbivora  under 
different  conditions,  with  a  full  consideration  of  their  digestive  peculiarities. 
Without  being  overburdened  with  details,  it  forms  a  complete  text-book  of 
physiology  adapted  to  the  use  of  students  and  practitioners  of  both  veterinary 
and  human  medicine.  This  work  has  already  been  adopted  as  the  Text-Book  on 
Physiology  in  the  Veterinary  Colleges  of  the  United  States,  Great  Britain,  and 
Canada.  In  one  Handsome  Royal  Octavo  Volume  of  over  950  pages,  profusely 
illustrated  with  more  than  400  Fine  Wood-Engravings  and  many  Colored  Plates. 

United  States.      Canada  (duty  paid)    Great  Britain.        France. 

Price,  Cloth,      -    -    $5.00,  Net         $5.50,  Net  28s.        30  fr.  30 

"     Sheep,    -    -     6.00    "  6.60    "  32s.         36  fr.  20 


A.  Liautard,  M.D.,  H.F.R.C.,  V.S.,  Pro- 
fessor of  Anatomy,  Operative  Surgery,  and 
Sanitary  Medicine  in  the  American  Veterinary 
College,  New  York,  writes: — ''I  have  exam- 
ined the  work  of  Dr.  R.  M.  Smith  on  the 
'Physiology  of  the  Domestic  Animals,'  and  con- 
sider it  one  of  the  best  additions  to  veterinary 
literature  that  we  have  had  for  some  time." 

E.  M.  Reading,  A.M.,  M.D.,  Professor  of 
Physiology  in  the  Chicago  Veterinary  College, 
writes: — "'I  have  carefully  examined  the 
'Smith's  Physiology,'  published  by  you,  and 
like  it.  It  is  comprehensive,  exhaustive,  and 
complete,  and  is  especially  adapted  to  those 
who  desire  to  obtain  a  full  knowledge  of  the 
principles  of  physiology,  and  are  not  satisfied 
with  a  mere  smattering  of  the  cardinal  points." 

Dr.  Smith's  presentment  of  his  subject  is  as 
brief  as  the  status  of  the  science  permits,  and 
to  this  much-desired  conciseness  he  has  added 
an  equally  welcome  clearness  of  statement. 
The  illustrations  in  the  work  arc  exceedingly 
good,  and  must  prove  a  valuable  aid  to  the 


full  understanding  of  the  text.— Journal  oj 
Comparative  Medicine  and  Surgery, 

Veterinary  practitioners  and  graduates  will 
read  it  with  pleasure.  Veterinary  students 
will  readily  acquire  needed  knowledge  from 
its  pages,  and  veterinary  schools,  which  would 
be  well  equipped  for  the  work  they  aim  to 
perform,  cannot  ignore  it  as  their  text-book 
in  physiology. — American  Veterinary  Jtevieiv. 
Altogether,  Professor  Smith's  "  Physiology 
of  the  Domestic  Animals"  is  a  happy  produc- 
tion, and  will  be  hailed  with  delight  in  both 
the  human  medical  and  veterinary  medical 
worlds.  It  should  find  its  place,  besides,  in  all 
agricultural  libraries.— Paul  Paquin,  M.D., 
\  .S.,  in  the  Weekly  Medical  Review. 

The  author  has  judiciously  made  the  nutri- 
tive functions  the  strong -point  of  the  work, 
and  has  devoted  special  attention  to  the  sub- 
ject  of    foods   and    digestion.      In    looking 
!   through  other  seetions  of  the  work,  it  appears 
[   to  us  that  a  just  proportion  of  space  is  assigned 
i  to  each,  in  view  of  their  relative  importance 
j  to  the  practitioner. — London  Lancet. 


SOZINSKEY 


Medical  Symbolism. 


Historical  Studies  in  the  Arts 
of  Healing-  and  Hygiene. 

By  Thomas  S.  Sozinskey,  M.D.,  Ph.D.,  Author  of  "The  Culture  of 
Beauty,"  "The  Care  and  Culture  of  Children,"  etc. 

12mo.  Nearly  200  pages.  Neatly  bound  in  Dark-Blue  Cloth.  Appropri- 
ately illustrated  with  upward  of  thirty  (30)  new  Wood-Engravings.  No.  9  in  the 
Physicians'  and  Students'  Heady-Reference  Series. 

Price,  post-paid,  in  United  States  and  Canada,  $1.00,  net;  Qreat 
Britain,  6s. ;  France,  6  fr.  20. 


He  who  has  not  time  to  more  fully  study  the 
more  extended  records  of  the  past,  will  highly 
prize  this  little  book.  Its  interesting  discourse 
upon  the  past  is  full  of  suggestive  thought. — 
American  Lancet. 

Like  an  oasis  in  a  dry  and  dusty  desert  of 
medical  literature,  through  which  we  wearily 
stagger,  is  this  work  devoted  to  medical  sym- 
bolism and  mythology.  As  the  author  aptly 
quotes:  "What  some  light  braines  may  esteem 
as  foolish  toyes,  deeper  judgments  can  and 


will  value  as  sound  and  serious  matter."— Can- 
adian Practitioner. 

In  the  volume  before  us  we  have  an  admira- 
ble and  successful  attempt  to  set  forth  in 
order  those  medical  symbols  which  have  come 
down  to  us,  and  to  explain  on  historical  grounds 
their  significance.  An  astonishing  amount  of 
information  is  contained  within  the  covers  of 
the  book,  and  every  page  of  the  work  bears 
token  of  the  painstaking  genius  and  erudite 
mind  of  the  now  unhappily  deceased  author. 
—London  Lancet. 


'23) 


Medical  Publications  of  The  F.  A.  Davis  Co.,  Philadelphia. 


STEWART 


Obstetric  Synopsis. 


By  John  S.  Stewart,  M.D.,  formerly  Demonstrator  of  Obstetrics  and 
Chief  Assistant  in  the  Gynaecological  Clinic  of  the  Medico-Chirurgical  College 
of  Philadelphia:  with  an  introductory  note  by  William  S.  Stewart,  A.M., 
M.D.,  Professor  of  Obstetrics  and  Gynaecology  in  the  Medico-Chirurgical  College 
of  Philadelphia. 

By  students  this  work  will  be  found  particularly  useful.  It  is  based  upon 
the  teachings  of  such  well-known  authors  as  Playfair,  Parvin,  Lusk,  Galabin, 
and  Cazeaux  and  Tarnier,  and  contains  much  new  and  important  matter  of  great 
value  to  both  student  and  practitioner. 

With  42  Illustrations.  202  pages.  12mo.  Handsomely  bound  in  Dark- 
Blue  Cloth.     No.  1  in  the  Physicians'  and  Students'  Ready -Reference  Series. 

Price,  post-paid,  in  the  United  States  and  Canada,  $1.00,  net;  in  Great 
Britain,  6s.;  France,  6  fr.  20. 


DeLaskie  Miller,  M.D.,  Professor  of 
Obstetrics,  Rush  Medical  College,  Chicago, 
111.,  says: — "I  have  examined  the  'Obstetric 
Synopsis,'  by  John  S.  Stewart,  M.D.,  and  it 
gives  me  pleasure  to  characterize  the  work  as 
systematic,  concise,  perspieuous,  and  authen- 
tic.   Among  manuals  it  is  one  of  the  best." 

It  is  well  written,  excellently  illustrated, 
and  fully  up  to  date  in  every  respect.  Here 
we  find  all  the  essentials  of  Obstetrics  in  a 
nutshell,  Anatomy,  Embryology,  Physiology, 
Pregnancy,  Labor,  Puerperal  State,  and  Ob- 
stetric Operations  all  being  carefully  and  ac- 


curately described. — Buffalo  Medical  and 
Surgical  Journal. 

It  is  clear  and  concise.  The  chapter  on  the 
development  of  the  ovum  is  especially  satis- 
factory. The  judicious  use  of  bold-faced 
type  for  headings  and  italics  for  important 
statements  gives  the  book  a  pleasing  typo- 
graphical appearance. — Medical  Record. 

This  volume  is  done  with  a  masterly  hand. 
The  scheme  is  an  excellent  one.  The  whole 
is  freely  and  most  admirably  illustrated  with 
well-drawn,  new  engravings,  and  the  book  is 
of  a  very  convenient  size. — St.  Louis  Medical 
and  Surgical  Journal. 


ULTZMANN 

The  Neuroses  of  the  Genito-Urinary  System 

in  the  Male. 

With  Sterility  and  Impotence. 

By  Dr.  R.  Ultzmann,  Professor  of  Genito-Urinary  Diseases  in  the  Uni- 
versity of  Vienna.  Translated,  with  the  author's  permission,  by  Gardner  W. 
Allen,  M.D.,  Surgeon  in  the  Genito-Urinary  Department,  Boston  Dispensary. 

Full  and  complete,  yet  terse  and  concise,  it  handles  the  subject  with  such 
a  vigor  of  touoh,  such  a  clearness  of  detail  and  description,  and  such  a  directness 
to  the  result,  that  no  medical  man  who  once  takes  it  up  will  be  content  to  lay  it 
down  until  its  perusal  is  complete, — nor  will  one  reading  be  enough. 

Professor  Ultzmann  has  approached  the  subject  from  a  somewhat  differct 
point  of  view  from  most  surgeons,  and  this  gives  a  peculiar  value  to  the  work. 
It  is  believed,  moreover,  that  there  is  no  convenient  hand-book  in  English  treat- 
ing in  a  broad  manner  the  Genito-Urinary  Neuroses. 

Synopsis  op  Contents. — First  Part — I.  Chemical  Changes  in  the  Urine  in 
Cases  of  Neuroses.  II.  Neuroses  of  the  Urinary  and  of  the  Sexual  Organs, 
classified  as  :  (1)  Sensory  Neuroses;  (2)  Motor  Neuroses  ;  (3)  Secretory  Neuroses. 
Second  Part — Sterility  and  Impotence.  The  treatment  in  all  cases  is  described 
clearly  and  minutely. 

Illustrated.  12mo.  Handsomely  bound  in  Dark-Blue  Cloth.  No.  4  in  the 
Physicians'  and  Students'  Ready -Reference  Series. 

Price,  post-paid,  in  the  United  States  and  Canada,  $1.00,  net ;  in  Great 
Britain,  6s. ;  in  France,  6  fr.  20. 


This  book  is  to  be  highly  recommended, 
owing  to  its  clearness  and  brevitv.  Altogether, 
we  do  not  know  of  any  book  of  the  same  size 
which  contains  so  much  useful  information  in 
such  a  short  space.— Medical  Neivs. 

Its  scope  is  large,  not  being  confined  to  the 
one  condition, — neurasthenia, — but  embracing 
all  of  the  neuroses,  motor  and  sensory  of  the 
genitourinary  organs  in  the  male.  No  one 
who  has  read  after  Dr.  Ultzmann  need  be  re- 


minded of  his  delightful  manner  of  presenting 
his  thoughts,  which  ever  sparkle  with  original- 
ity and  appositeness. —  Weekly  Med.  Review. 

It  engenders  sound  pathological  teaching, 
and  win  aid  in  no  small  degree  in  throwing 
light  on  the  management  of  many  of  the  dif- 
ficult and  more  refractory  cases  of  the  classes 
to  which  these  essays  especially  refer.— The 
Medical  Age. 


(24) 


Medical  Publications  of  The  F.  A.  Davis  Co.,  Philadelphia. 


Diphtheria,  Croup:   Tracheotomy  and 
Intubation. 

From  the  French  of  A.  Sann£. 

Translated  and  enlarged  by  Henry  Z.  Gill,  M.D.,  LL.D.,  Late  Professor  of  Surgery 
In  Cleveland,  Ohio. 

Satme's  work  Is  quoted,  directly  or  indirectly,  by  every  writer  since  its  publication, 
as  the  highest  authority,  statistically,  theoretically,  and  practically.  The  trauslator,  having 
given  special  study  to  the  subject  for  many  years,  has  added  over  fifty  pages,  including  the 
Surgical  Anatomy,  Intubation,  and  the  recent  progress  iu  other  branches,  making  it, 
beyond  questiou,  the  most  complete  work  extant  on  the  subject  of  Diphtheria  in  the 
English  language. 

Facing  the  title-page  is  found  a  very  fine  Colored  Lithograph  Plate  of  the  parts  con- 
cerned in  Tracheotomy.  Next  follows  an  illustration  of  a  cast  of  the  entire  Trachea  and 
Bronchi  to  the  third  or  fourth  division,  in  one  piece,  taken  from  a  photograph  of  a  case  in 
which  the  cast  wa6  expelled  during  life  from  a  patieut  sixteen  years  old.  This  is  the  most 
complete  cast  of  any  one  recorded. 

Over  fifty  other  illustrations  of  the  surgical  anatomy  of  instruments,  etc.,  add  to  the 
practical  value  of  the  work. 

A  full  Index  accompanies  the  enlarged  volume,  also  a  List  of  Authors,  making 
altogether  a  very  handsome  illustrated  octavo  volume  of  over  680  pages. 

United  States.    Canada  (duty  paid).    Great  Britain.  France. 

Price,  post-paid,  Cloth,  $4.00,  Net        $4.40,  Net         22s.  Ci        24  fr.  60 

Leather,         5.00    "  5.50    •  28s.  30  fr.  30 


YOUNG 

Synopsis  of  Human  Anatomy. 

Being  a  Complete  Compend  of  Anatomy,  Including  the  Anatomy  of 
the  Viscera,  and  Numerous  Tables. 

By  James  K.  Young,  M.D.,  Instructor  in  Orthopaedic  Surgery  and  Assistant  Demon- 
strator of  Surgery,  University  of  Pennsylvania;  Attending  Orthopaedic  Surgeon,  Out- 
Patient  Department,  University  Hospital,  etc. 

While  the  author  has  prepared  this  work  especially  for  students,  sufficient  descriptive 
matter  has  been  added  to  render  it  extremely  valuable  to  the  busy  practitioner,  particularly 
the  sections  on  the  Viscera,  Special  Senses,  and  Surgical  Anatomy. 

The  work  includes  a  complete  account  of  Osteology,  Articulations  and  Ligaments, 
Muscles,  Fascias,  Vascular  and  Nervous  Systems,  Alimentary,  Vocal,  and  Respiratory  and 
Genito-fJrinary  Apparatus,  the  Organs  of  Special  Sense,  and  Surgical  Anatomy. 

In  addition  to  a  most  carefully  and  accurately  prepared  text,  wherever  possible,  the 
value  of  the  work  has  been  enhanced  by  tables  to  facilitate  aud  minimize  the  labor  of  stu- 
dents in  acquiring  a  thorough  knowledge  of  this  important  subject.  The  section  on  the 
teeth  has  also  been  especially  prepared  to  meet  the  requirements  of  students  of  dentistry. 

Illustrated  with  76  Wood-Engravings.  390  pages.  12mo.  Bound  in  Extra  Dark- 
Blue  Cloth.     No.  S  in  live  Pkysiciatis'  and  Students'  Ready-Reference  Series. 

Price,  post-paid,  in  the  United  States  and  Canada,  $1.40,  net;  in  Great 
Britain,  8s.  6d ;  in  France,  9  fr.  25. 


Every  unnecessary  word  has  been  excluded, 
out  of  regard  to  the  very  limited  time  at  the 
medical  student's  disposal.  It  is  also  good  as 
a  reference-book,  as  it  presents  the  facts  about 
which  he  wishes  to  refresh  his  memory  in  the 
briefest  manner  consistent  with  clearness. — 
New  York  Medical  Journal. 

As  a  companion  to  the  dissecting-table,  and 
a  convenient  reference  for  the  practitioner,  it 

(25) 


hns  a  definite  field  of  usefulness.— Pittsbur g h 
Medical  Review. 

The  book  is  much  more  satisfactory  than  the 
"remembrances"  in  vopme,  and  yet  is  not  too 
cumbersome  to  he  carried  around  and  read  at 
odd  moments— a  property  which  the  student 
will  readily  appreciate.  —  Weekly  Medical 
Review. 


Medical  Publications  of  The  F.  A.  Davis  Co.,  Philadelphia. 
WITHERSTI2TE 

The  International  Pocket  Medical  Formulary 

Arranged  Therapeutically. 

By  C.  Sumner  Witherstine,  M.S.,  M.D.,  Associate  Editor  of  the 
"Annual  of  the  Universal  Medical  Sciences  ;"  Visiting  Physician  of  the  Home 
for  the  Aged,  Gennantown,  Philadelphia  ;  Late  House-Surgeon  Charity  Hospital, 
New  York. 

More  than  1800  formulae  from  several  hundred  ■well-known  authorities. 
With  an  Appendix  containing  a  Posological  Table,  the  newer  remedies  included  ; 
Important  Incompatibles  ;  Tables  on  Dentition  and  the  Pulse  ;  Table  of  Drops 
in  a  Fluidrachm  and  Doses  of  Laudanum  graduated  for  age  ;  Formulae  and  Doses 
of  Hypodermatic  Medication,  including  the  newer  remedies  ;  Uses  of  the  Hypo- 
dermatic Syringe  ;  Formulae  and  Doses  for  Inhalations,  Nasal  Douches,  Gargles, 
and  Eye-washes  ;  Formulae  for  Suppositories  ;  Use  of  the  Thermometer  in  Dis- 
ease ;  Poisons,  Antidotes,  and  Treatment ;  Directions  for  Post-Mortem  and 
Medico-Legal  Examinations ;  Treatment  of  Asphyxia,  Sun-stroke,  etc.  ;  Anti- 
emetic Remedies  and  Disinfectants  ;  Obstetrical  Table  ;  Directions  for  Ligations 
of  Arteries  ;  Urinary  Analysis  ;  Table  of  Eruptive  Fevers  ;  Motor  Points  for 
Electrical  Treatment,  etc. 

This  work,  the  best  and  most  complete  of  its  kind,  contains  about  275 
printed  pages,  besides  extra  blank  leaves — the  book  being  interleaved  throughout 
— elegantly  printed,  with  red  lines>  edges,  and  borders;  with  illustrations.  Bound 
in  leather,  with  side  flap. 

It  is  a  handy  book  of  reference,  replete  with  the  choicest  formulae  (over 
1800  in  number)  of  more  than  six  hundred  of  the  most  prominent  classical  writers 
and  modern  practitioners. 

The  remedies  given  are  not  only  those  whose  efficiency  has  stood  the  test 
of  time,  but  also  the  newest  and  latest  discoveries  in  pharmacy  and  medical 
science,  as  prescribed  and  used  by  the  best-known  American  and  foreign  modern 
authorities. 

It  contains  the  latest,  largest  (66  formulae),  and  most  complete  collection  of 
hypodermatic  formula;  (including  the  latest  new  remedies)  ever  published,  with 
doses  and  directions  for  their  use  in  over  fifty  different  diseases  and  diseased 
conditions. 

Its  appendix  is  brimful  of  information,  invaluable  in  office  work,  emergency 
cases,  and  the  daily  routine  of  practice. 

It  is  a  reliable  friend  to  consult  when,  in  a  perplexing  or  obstinate  case,  the 
usual  line  of  treatment  is  of  no  avail.  (A  hint  or  a  help  from  the  best  authorities, 
as  to  choice  of  remedies,  correct  dosage,  and  the  eligible,  elegant,  and  most  palat- 
able mode  of  exhibition  of  the  same.) 

It  is  compact,  elegantly  printed  and  bound,  well  illustrated,  and  of  conve- 
nient size  and  shape  for  the  pocket. 

The  alphabetical  arrangement  of  the  diseases  and  a  thumb-letter  index 
render  reference  rapid  and  easy. 

Blank  leaves,  judiciously  distributed  throughout  the  book,  afford  a  place  to 
record  and  index  favorite  formulae. 

As  a  student,  the  physician  needs  it  for  study,  collateral  reading,  and  for 
recording  the  favorite  prescriptions  of  his  professors,  in  lecture  and  clinic;  as  a 
recent  graduate,  he  needs  it  as  a  reference  hand-book  for  daily  use  in  prescribing 
(gargles,  nasal  douches,  inhalations,  eye-washes,  suppositories,  incompatibles, 
poisons,  etc.);  as  an  old  practitioner,  he  needs  it  to  refresh  his  memory  on  old 
remedies  and  combinations,  and  for  information  concerning  newer  remedies  and 
more  modern  approved  plans  of  treatment. 

No  live,  progressive  medical  man  can  afford  to  be  without  it. 

Price,  post-paid,  in  United  States  and  Canada  $2.00,  net ; 
Great  Britain,  lis.  61 ;  France,  12  fr.  10. 

It  is  sometimes  important  that  such  prescrip- 
tions as  have  been  well  established  in  their 
usefulness  be  preserved  for  reference,  and 


this  little  volume  serves  such  a  purpose  better 
than  any  other  we  have  seen. — Columbus  Med- 
ical Journal. 

To  the  young  physiciun  just  starting  out  in 
practice  this  little  book  will  prove  an  accept- 
able companion. — Omaha  Clinic. 

As  long  as  "combinations"  are  sought,  such 
a  book  will  be  of  value,  especially  to  those 
who  cannot  spare  the  time  required  to  learn 


enough  of  incompatibilities  before  commenc- 
ing practice  to  avoid  writing  incompatible  and 
dangerous  prescriptions.  The  constant  use  of 
such  a  book  by  such  prescribers  would  save 
the  pharmacist  much  anxiety. — The  Drug- 
gists* Circular. 

In  judicious  selection,  in  accurate  nomen- 
clature,  in  arrangement,  and  in  style,  it  leaves 
nothing  to  be  desired.  The  editor  and  the 
publisher  are  to  be  congratulated  on  the  pro- 
duction of  the  very  best  book  of  its  class.— 
Pittsburgh  Medical  Review. 

(26) 


Medical  Publications  of  The  F.  A.  Davis  Co.,  Philadelphia. 

Annual  of  the  Universal  Medical  Sciences. 

A  Yearly  Report  of  the  Progress  of  the  General  Sanitary 
Sciences  Throughout  the  World. 

Edited  by  Charles  E.  Sajous,  M.D.,  formerly  Lecturer  on  Laryngology 
and  Rhinology  in  Jefferson  Medical  College,  Philadelphia,  etc.,  and  Seventy 
Associate  Editors,  assisted  by  over  Two  Hundred  Corresponding  Editors  and 
Collaborators.  In  Five  Royal  Octavo  Volumes  of  about  500  pages  each,  bound 
in  Cloth  and  Half-Russia,  Magnificently  Illustrated  with  Chromo-Lithographs, 
Engravings,  Maps,  Charts,  and  Diagrams.  Being  intended  to  enable  any  physi- 
cian to  possess,  at  a  moderate  cost,  a  complete  Contemporary  History  of  Universal 
Medicine,  edited  by  many  of  America's  ablest  teachers,  and  superior  in  every 
detail  of  print,  paper,  binding,  etc.,  a  befitting  continuation  of  such  great  works 
as  "Pepper's  System  of  Medicine,"  "  Ashhurst's  International  Encyclopaedia  of 
Surgery,"  "Buck's  Reference  Hand-Book  of  the  Medical  Sciences." 


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93  fr.  95 ;  Half-Russia,  124  fr.  35. 

The  Satellite  of  the  "Annual  of  the  Universal  Medical  Sciences."  A 
Monthly  Review  of  the  most  important  articles  upon  the  practical  branches  of 
Medicine  appearing  in  the  medical  press  at  large,  edited  by  the  Chief  Editor  of 
the  Annual,  and  an  able  staff.  Published  in  connection  with  the  Annual,  and 
for  its  Subscribers  OnSy. 


Editorial  Staff  of  the  Annual  of  the  Universal  Medical  Sciences. 

CONTRIBUTORS  TO  SERIES  1888,  1889,  1890,  1891. 

Editor-in-Chief,  CHARLES  E.  SAJOUS,  M.D.,  Philadelphia. 


SENIOR   ASSOCIATE    EDITORS. 

Agnew,  D.  Haves,  M.D.,  LL.D.,  Philadelphia, 

series  of  1888.  1889. 
Baldy,  J.  ML  M.D.,  Philadelphia,  1891. 
Barton,  J.  M.,  A.M.,  M.D.,  Philadelphia,  1889, 

1K90,  1891. 
Birdsall,  W.  R.,  M.D.,  New  York,  1889,  1890, 

1891. 
Brown,  F.  W.,  M.D.,  Detroit,  1890,  1891. 
Bruen,  Edward  T.,  M.D.,  Philadelphia,  1889. 
Brush,  Edward  N.,   M.D.,  Philadelphia,  1889, 

1890,  1891. 
Cohen.  J.  Kolis,  M.D.,  Philadelphia,  1888,  1889, 

1890,  1891. 
Conner,  P.  8.,  M.D.,  LL.D.,  Cincinnati,  1888, 

1889,  1890,  1891. 
Currier,  A.  F.,  A.B.,  M.D.,  New  York,   1889, 

1890  1891 
Davidson,  C.C.,  M  D.,  Philadelphia.  1888. 
Davis.  N.  S.,  A.M.,  M.D.,  LL.D.,  Chicago,  1888, 

1889,  1890,  1891. 

Delafleld,  Francis,  M.D.,  New  York.  1888. 
Delavan,  D.  Bryson,  M.D.,   New  York,  1888, 

1889,1890,1891. 
Draper,  F.  Winthrop.  A.M.,  M.D.,  New  York, 

1888,  1889,  1890.  1891. 
Dudley,  Edward  C,  M.D.,  Chicago,  1888. 
Ernst.   Harold  C,   A.M.,  M.D.,  Boston,  1889, 

1890,  1891. 

Forbes,  William  S.,  M.D.,  Philadelphia,  1888, 

1889  1890 
Garretson,    J.   E.,   M.D..    Philadelphia,    1888, 


Gaston,  J.   McFadden,  M.D.,    Atlanta,    1890, 

1801. 
Gihon.  Albert  L.,  A.M.,  M.D„  Brooklyn,  1888, 

1889.  1890.  1891. 
Goodell.  William.   M.D.,    Philadelphia,    1888, 

1889.  1890. 

Grav,  Landon  Carter,  M.D.,  NewYork,  1890, 

1891. 
Griffith.  .T.  P.  Crozer,  M.D.,  Philadelphia,  1889. 

1890.  1891. 

Guilford,  S.  H.,  D.D.S.,  Ph.D.,  Philadelphia, 

1888 
Guite'ras,  John,  M.D.,  Ph,D.,  Charleston,  1888, 

1889 
Hamilton.  John  B..  M.D.,  LL.D.,  Washington, 

1888.  1889,  1890.  1891. 

Hare.  Hobart  Aniorv.  M.D.,  B.Sc,  Philadel- 
phia. 1888,  1889.  1891).  1891. 

Henrv.  Frederick  P.,  M.D.,  Philadelphia,  1889, 
1890,  1891. 

Holland,  .1.  W.,  M.D..  Philadelphia,  1888.  1889. 

Holt.  L.  Emmett,  M.D.,  New  York,  1889,  1890, 
1891. 

Howell.   W.     H..    Ph.D.,   M.D.,   Ann    Arbor, 

1889.  1890,  1891. 

Hnn.  Henry,  M.D.,  Albanv,  1889.  1890. 
Hooper.  Franklin  H,  M.D..  Boston,  1890,  1891. 
Ingals.  E.  Fletcher,  A.M.,  M.D.,  Chicago,  1889, 

1890.  1891. 

.laggard,  W.  W.,  A.M.,  M.D.,  Chicago.  1890. 
Johnston,  Christopher,  M.D.,  Baltimore,  1888, 

1889. 
Johnston.  W.  W.,  M.D.,  Washington,  1888, 1889, 

1890,  i891. 


(27) 


Medical  Publications  of  The  F.  A.  Davis  Co.,  Philadelphia. 


SENIOR  ASSOCIATE    EDITORS 

(CONTINUED). 

Keating,  John  M.,  M.D.,  Philadelphia,  1889. 
Kelsey,  Charles  B.,  M.D.,  New  York,  1888, 1889, 

1890,  1891. 
■Keyes,  Kdward  I,.,  A.M.,  M.D.,  New  York, 

1888. 1889,  1890,  1891. 

Knapp,  Philip  Coombs,  M.D.,  Boston,  1891. 
Laplace,    Ernest,  A.M.,  M.D.,  Philadelphia, 

1890  1891 
Lee,  John  g!,  M.D.,  Philadelphia,  1888. 
Leidy,  Joseph,  M.D.,  LL.D.,  Philadelphia,  1888, 

1889,  1890,  1891. 
Longstreth,  Morris,  M.D.,  Philadelphia,  1888, 

1889,  1890. 

Loomis,  Alfred  L.,  M.D.,   LL.D.,  New  York. 

1888,  1889. 
Lyman,  Henry  M.,  A.M.,  M.D.,  Chicago,  1888. 
McGuire,  Hunter,  M.D.,   LL.D.,   Richmond, 

1888. 
Manton,  Walter  P.,  M.D.,  F.R.M.S.,  Detroit, 

1888,  1889,  1890,  1891. 

Martin,  H.  Newell,  M.D.,  M.A.,  Dr.  Sc,  F.R.S., 

Baltimore,  1888, 1889. 
Matas,  Rudolph,    M.D.,  New    Orleans,    1890, 

1891. 
Mears,  J.  Ewing,  M.D.,  Philadelphia,  1888, 1889, 

1890,  1891. 

Mills,  Charles  K.,  M.D.,  Philadelphia,  1888. 
Minot,  Chas.   Sedgwick,  M.D.,  Boston,  1888, 

1889. 1890,  1891. 

Montgomery,  E.  E.,  M.D.,  Philadelphia,  1891. 
Morton,  Thos.  G.,   M.D.,   Philadelphia,  1888, 

1889. 
Munde,  Paul  F.,  M.D.,  New  York,  1888,  1889, 

1890,  1891. 
Oliver,  Charles  A.,  A.M.,  M.D.,  Philadelphia, 

1889,  1890,  1891. 

Packard,  John  H.,  A.M.,  M.D.,  Philadelphia, 

1888,  1889,  1890,  1891. 

Parish,  Wm.H.,  M.D.,  Philadelphia,  1888, 1889, 
1890. 

Parvin,  Theophilus,  M.D.,  LL.D.,  Philadel- 
phia, 1888,  1889. 

Pierce,  C.  N.,  D.D.S.,  Philadelphia,  1888. 

Pepper,  William,  M.D.,  LL.D.,  Philadelphia, 
1888. 

Rannev,  Ambrose  L.,  M.D.,  New  York,  1888, 

1889,  1890. 

Richardson,  W.  L.,  M.D.,Boston,  1888,  1889. 
Rockwell,  A.  D.,  A.M..  M.D.,  New  York,  1891. 
Rolie".  Geo.  H.,  M.D.,  Baltimore.  1888, 1889, 1890, 

1891. 
Sajous,  Chas.  E.,  M.D.,  Philadelphia.  1888, 1889, 

1890. 1891, 

Sayre,  Lewis  A.,  M.D.,  New  York,  1890.  1891. 
Seguin,  E.  C,  M.D.,   Providence,   1888,  1889, 

1890,  1891. 

Senn,  Nicholas,  M.D.,  Ph.D.,  Milwaukee,  1888, 

1889. 
Shakspeare.  E.  O.,  M.D.,  Philadelphia,  1888. 
Shattuck,  F.  C,  M.D.,  Boston,  1890. 
Smith.  Allen  J.,  A.M.,  M.D.,  Philadelphia,  1890, 

1891. 
Smith,  J.  Lewis,  M.D.,  New  York,  1888,  1889, 

1890,  1891. 
Spitzka,  E.  C,  M.D.,  New  York.  1888. 
Starr,   Louis,   M.D.,   Philadelphia,  1888,  1889, 

1890.  1891. 
Stimson.  Lewis  A.,  M.D.,  New  York,  1888,  1889, 

1890,  1891. 
Siurgis.  F.  R,MD.,  New  York.  1888. 
Sudduth,  F.  X.,  A.M..  M.D..  F.R.M.S.,  Minne- 
apolis, 1888,  1889,  1890, 1891. 
Thomson,  William,  M.D.,  Philadelphia.  1888. 
Thomson,  Wm.  H.,  M.D..  New  York,  1888. 
Tiffanv,  L.  McLane,  A.M.,  M.D.,  Baltimore, 

1890.  1891. 
Turnbull.  Chas.  S.,  M.D.,  Ph.D.,  Philadelphia, 

1888.  1889,  1890  1891. 
Tyson.  James,  M.D.,  Philadelphia,  1888,  1889, 

1890.  ' 

Van  Harlingen,  Arthur,  M.D.,  Philadelphia, 

1888,  1889,  1890. 1891. 
Vander  Veer,  Albert,  M.D.,  Ph.D.,  Albanv, 

1890.  J' 

Whittnker.  Jas.  T.,  M.D.,  Cincinnati,  1888, 1889, 

1890,1891.  ' 

Whittier,  E.  N.,  M.D..  Boston,  1890,  1891. 
Wilson,  James  C,  A.M.,  M.D.,  Philadelphia, 

1888. 1889.  1890,  1891. 


Wirgman,  Chas.,  M.D.,  Philadelphia,  1888. 

Witherstine,  C.  Sumner,  M.S.,  M.D.,  Phila- 
delphia, 1888,  1889,  1890,  1891. 

White,  J.  William,  M.D.,  Philadelphia,  1889, 
1890,1891. 

Young,  Jas.  K.,  M.D.,  Philadelphia,  1891. 

JUNIOR   ASSOCIATE    EDITORS. 

Baldy,  J.  M.,  M.D.,  Philadelphia,  1890. 

Bliss.  Arthur  Ames,  A.  M.,  M.D.,  Philadelphia, 

1890,  1891. 
Cattell,  H.  W    M.D..  Philadelphia,  1890,  1891. 
Cerna,  David,  M.D.,  PhD..  Philadelphia,  1891. 
Clark,  J.  Payson,  M.D.,  Boston,  1890.  1891. 
Crandall,  F.  M..  M.D.,  New  York,  1891. 
Cohen,  Solomon  Solis,  A.M.,.  M.D.,  Philadel- 
phia, 1890,  1891, 
Cryer,  H.  M.,  M.D.,  Philadelphia.  1889. 
Deale,  Henry  B.,  M.D.,  Washington,  1891. 
Dolley,  C.  S..  M.D.,   Philadelphia,  1889,  1890, 

1891. 
Dollinger,  Julius,  M.D.,  Philadelphia,  1889. 
Dorland,  W.  A.,  M.D.,  Philadelphia.  1891. 
Freeman,  Leonard,  M.D.,  Cincinnati,  1891. 
Goodell,  W.  Constantine,  M.D.,  Philadelphia, 

1888,  1889,  1890. 
Gould.  Geo.  M..M.D..  Philadelphia,  1889,  1890. 
Greene,  E.  M..  M.D.,  Boston,  1891. 
Griffith,  J.  P.  Crozer,  M.D.,  Philadelphia,  1883. 
Hoag,  Junius,  M.D.,  Chicago,  1888. 
Howell,  W.  H.,  PhD.,  B.A.,  Baltimore,  1888, 

1889. 
Hunt,  William,  M.D.,  Philadelphia,  1888,  1889. 
Jackson.  Henry  M.D.,  Boston,  1891. 
Kirk,  Edward  C.,  D.D.S..  Philadelphia,  1888. 
Llovd,  James   Hendrie,  M.D.,  Philadelphia, 

1888 
McDonald,  Willis  G.,  M.D.,  Alhanv,  1890. 
Penrose,  Chas.  B.,  M.D..  Philadelphia.  1890. 
Powell.  W.  M.,  M.D.,  Philadelphia,  1889,  1890, 

1891. 
Quimby,  Chas.  E.,  M.D.,  New  York,  1889. 
Sayre,  Reginald  H,  M.D.,  New  York,  1890, 1891. 
Smith,    Allen  J.,  A.M.,  M.D.,    Philadelphia, 

1889, 1890. 
Vickery,  H.  F.,  M.D.,  Boston,  1891. 
Warfield.  Ridgelv  B.,  M.D.,  Baltimore,  1891. 
Warner,  Frederick  M.,  M.D..  New  York.  1891. 
Weed.  Charles  L.,  A.M.,  M.D.,  Philadelphia, 

1888, 1889. 
Wells.  Brooks  H.,  M.D.,  New  York,  1888,  1889, 

1890  1891 
Wolff,  Lawrence,  M.D.,  Philadelphia,  1890. 
Wyman,  Walter,   A.M.,  M.D.,    Washington, 

1891. 

ASSISTANTS    TO    ASSOCIATE 
EDITORS. 

Baruch,  S.,  M.D.,  New  York,  1888. 
Beatty,  Franklin  T.,  M.D.,  Philadelphia,  1888. 
Brown,  Dillon,  M.D..  New  York.  1888. 
Buechler,  A.  F.,  M.D.,  New  York,  1888. 
Burr,  Chas.  W.,  M.D..  Philadelphia,  1891. 
Cohen.  Solomon   Solis,    M.D.,    Philadelphia, 

1889. 
Cooke,  B.  G.,  M.D.,  New  York,  1888. 
Coolidge,  Algernon,  Jr.,  M.D.,  Boston,  1890. 
Currier,  A.  F.,  M.D.,  New  York,  1888. 
Daniels.  F.  H.,  A.M.,  M.D.,  New  York.  1888. 
Deale,  Henry  B.,  M.D.,  Washington.  1890. 
Eshner,  A.  A^M.D.,  Philadelphia,  1891. 
Gould,  George  M.,  M.D.,  Philadelphia,  1888. 
Grandin,  Egbert  H.,  M.D.,  New  York,  1888, 

1889. 
Greene,  E.  M..  M  D.,  Boston,  1890. 
Guite'ras,  G.  M.,  M.D..  Washington,  1890. 
Hance,  I.  H.,  A.M.,  M.D.,  New  York,  1891. 
Klingenschmidt,  C.  H.  A.,  M.D.,  Washington, 

1890  ' 

Martin.' Edward,  M.D.,  Philadelphia,  1891. 
McKee,  E.  S.,  M.D.,  Cincinnati,  1889, 1890, 1891. 
Mvers.  F.  H.,  M.D..  New  York,  1888. 
Packard.  F.  A.,  M.D..  Philadelphia.  1890. 
Pritchard.  W.  B.,  M.D.,  New  York,  1891. 
Sangree,  E.  B..  A.M.,  M.D.,  Philadelphia,  1890. 
Sears,  G.  G.,  M.D..  Boston,  1890. 
Shulz,  R.  C,  M.D.,  New  York,  1891. 
Souwers,  Geo.  F.,  M.D.,  Philadelphia.  1888. 
Tavlor,  H.  L.  M.D.,  Cincinnati,  1889,  1890. 
Vansant,  Eugene  L.,  M.D.,  Philadelphia,  1888. 


(28) 


Medical  Publications  of  The  F.  A.  Davis  Co.,  Philadelphia. 


ASSISTANTS    TO    ASSOCIATE  . 

EDITORS-(CONTINUED). 

Vickery,  H.  F-  M.D.,  Boston,  1890.      '  _ 

Warner,  F.  M.,  M.D.,  New  York,  1888,  1889, 

1890 
Wells,  Brooks  H.,  M.D.,  New  York.  1888. 
Wendt,  E.  C,  M.D.,  New  York,  1888. 
Wilder,  W.  H.,  M.D.,  Cincinnati,  1889. 
Wilson,  O.  Meigs,  M.D.,  Philadelphia,  1889. 
Wilson,  W.  K.,  M.D.,  Philadelphia,  1891. 

CORRESPONDING    STAFF. 
EUROPE. 
Antal,  Dr.  Gesa  v.,  Puda-Pesth,  Hungary. 
Baginsky,  Dr.  A.,  Berlin,  Germany. 
Bai  atoux,  Dr.  J.,  Paris,  Fiance. 
Barker,  Mr.  A.  E.  J.,  London,  England. 
Barnes,  Dr.  Faneourt,  London,  England. 
Bayer,  Dr.  Carl,  Prague,  Austria. 
Bouchut,  Dr.  E.,  Par.s,  France. 
Bourne ville,  Dr.  A.,  Paris,  France. 
BramwelL,  Dr.  Byron,  Edinburgh,  Scotland. 
Carter,  Mr.  William,  Liverpool,  England. 
Caspari,  Dr.  G.  A.,  Moscow,  Russia. 
Chiralt  v  Selma,  Dr.  V.,  Seville,  Spain. 
Cordes,  Dr.  A.,  Geneva,  Switzerland. 
D'Estrees,  Dr.  Debout,  Contrexeville,  France. 
Diakonoff,  Dr.  P.  J.,  Moscow,  Russia. 
Dobrashian,  Dr.  G.  S.,  Constantinople,  Tur- 

Dole'ris,  Dr.  L.,  Paris,  France. 
Doutrelepont,  Prof.,  Bonn,  Germany. 
Doyon,  Dr.  H..  Lyons,  France. 
Drzewiecki,  Dr.  Jos.,  Warsaw,  Poland. 
Dubois-Reymond,  Prof.,  Berlin,  Germany. 
Ducrey,  Dr.- A.,  Naples,  Italy. 
Duiardin-Beaumetz,  Dr.,  Paris  France. 
Duke,  Dr.  Alexander,  Dublin,  Ireland. 
Eklund,  Dr.  F.,  Stockholm,  Sweden. 
Fokker,  Dr.  A.  P.,  Groningen,  Holland. 
Fort,  Dr.  J.  A.,  Paris,  France. 
Founder,  Dr.  Henri,  Paris,  France. 
Franks,  Dr.  Kendal,  Dublin,  Ireland. 
Fremv.  Dr.  H.,  Nice,  France. 
Fry,  Dr.  George,  Dublin,  Ireland 
Golowina,  Dr.  A.,  Varna,  Bulgaria. 
Gouguenheim,  Dr.  A.,  Paris,  France. 
Haig,  Dr.  A.,  London,  England. 
Hamon,  Mr.  A.,  Paris,  France. 
Harley,  Mr.  V.,  London,  England. 
Harley,  Mr.  H.  R.,  Nottingham,  England. 
Harley,  Prof.  Geo.,  London,  England. 
Harpe,  Dr.  de  la,  Lausanne,  Switzerland. 
Hartmann,  Prof.  Arthur,  Berlin,  Germany. 
Heitzmann,  Dr.  J.,  Vienna,  Austria. 
Helferich,  Prof.,  Greifswald,  Germany. 
Hewetson,  Dr.  Bendelack,  Leeds,  England. 
Hoff,  Dr.  E.  M.,  Copenhagen,  Denmark. 
Humphreys,  Dr.  F.  Rowland,  London,  Eng- 
land. 
IMingworth,  Dr.  C.  K.,  Accrington,  England. 
Jones,  Dr.  D.  M.  de  Silva,  Lisbon,  Portugal. 
Knott,  Dr.  J.  F.,  Dublin,  Ireland. 
Krause,  Dr.  H.,  Berlin,  Germany. 
Landolt,  Dr.  E.,  Paris,  France. 
Levison,  Dr.  J.,  Copenhagen,  Denmark. 
Lutaud,  Dr.  A.,  Paris,  France. 
Mackay,  Dr.  W.  A.,  Huelva,  Spain. 
Mackowen,  Dr.  T.  C,  Capri,  Italy. 
Manche,  Dr.  L.,  Valetta,  Malta. 
Massei,  Prof.  F.,  Naples,  Italy. 
Mendez,  Prof.  R,  Barcelona,  Spain. 
Meyer,  Dr.  E..  Naples,  Italy. 
Meyer,  Prof.  W.,  Copenhagen.  Denmark. 
Monod,  Dr.  Charles.  Paris,  France. 
Montefusco,  Prof.  A.,  Naples,  Italy. 
More-Madden,  Prof.  Thomas,  Dublin,  Ireland. 
Morel,  Dr.  J.,  Ghent,  Belgium. 
Mygind,  Dr.  Holger,  Copenhagen,  Denmark. 
Mynlieff,  Dr.  A.,  Breukelen,  Holland. 
Napier,  Dr.  A.  D.  Leith.  London,  England. 
Nicolich,  Dr..  Trieste,  Austria. 
Oberlander,  Dr.,  Dresden,  Germany. 
Obersteiner,  Prof.,  Vienna,  Austria. 
Pampoukis,  Dr.,  Athens,  Greece. 
Pansoni,  Dr.,  Naples,  Italy. 
Parker,  Mr.  Rushton,  Liverpool,  England. 
Pel,  Prof.  P.  K.,  Amsterdam,  Holland. 
Pippinskjold,  Dr.,  Helsingfors.  Finland. 
Pulido,  Prof.  Angel,  Madrid,  Spain. 


R6na,  Dr.  S.,  Buda-Pesth,  Hungary. 

Rosenbusch,  Dr.  L.,  Lvov.  Galicia. 

Rossbach,  Prof.  M.  F.,  Jena,  Germany. 

St.  Germain,  Dr.  de,  Paris,  France. 

Sanger,  Prof.  M.,  Leipzig,  Germany. 

Santa,  Dr.  P.  de  Pietra,  Paris,  France. 

Schiffers,  Prof.,  Liege.Belgium. 

Schmiegelow,  Prof.  E.,  Copenhagen,  Den- 
mark. 

Scott,  Dr.  G.  M.,  Moscow,  Russia. 

Simon,  Dr.  Jules,  Paris,  France. 

Sollier,  Dr.  P.,  Paris,  France. 

Solowieff,  Dr.  A.  N.,  Lipetz,  Russia. 

Sota,  Prof.  R.  de  la,  Seville,  Spain. 

Sprimont,  Dr.,  Moscow,  Russia. 

Stockvis,  Prof.  B.  J.,  Amsterdam,  Holland. 

Szadek,  Dr.  Carl,  Kiew,  Russia. 

Tait,  Mr.  Lawson,  Birmingham,  England. 

Thiriar,  Dr.,  Brussels,  Belgium. 

Trifiletti,  Dr.,  Naples,  Italy. 

Tuke,  Dr.  D.  Hack,  London,  England. 

Ulrik,  Dr.  Axel,  Copenhagen,  Denmark. 

Unverricht,  Prof.,  Jena,  Germany. 

Van  der  Mey,  Prof.  G.  H.,  Amsterdam,  Hol- 
land. 

Van  Leent,  Dr.  F.,  Amsterdam,  Holland. 

Van  Millingen,  Prof.  E.,  Constantinople,  Tur- 
key. 

Van  Rijnberk,  Dr.,  Amsterdam,  Holland. 

"Wilson,  Dr.  George,  Leamington,  England. 

Wolfenden,  Dr.  Norris,  London,  England. 

Zweifel,  Prof.,  Leipzig,  Germany. 

AMERICA     AND     WEST     INDIES. 

Bittencourt,  Dr.  J.  C,  Rio  Janeiro,  Brazil. 
Cooper,  Dr.  Austin  N.,  Buenos  Ayres,  Argen- 
tine Republic. 
Dagnino,  Prof.  Manuel,  Caracas,  Venezuela. 
Desvernine,  Dr.  C.  M.,  Havana,  Cuba. 
Fernandez,  Dr.  J.  L.,  Havana,  Cuba. 
Finlay,  Dr.  Charles,  Havana,  Cuba. 
Fontecha,  Prof.  R.,  Tegucigalpa,  Honduras. 
Harvey,  Dr.  Eldon,  Hamilton,  Bermuda. 
Herdocia,  Dr.  E.  Leon,  Nicaragua. 
Levi,  Dr.  Joseph,  Colon,  U.  S.  Columbia. 
Mello.  Dr.  Vierra  de,  Rio  Janeiro,  Brazil. 
Moir,  Dr.  J.  W.,  Belize,  British  Honduras. 
Moncorvo,  Prof.,  Rio  Janeiro,  Brazil. 
Pla,  Dr.  E.  F.  Havana,  Cuba. 
Rake,  Dr.  Beaven,  Trinidad. 
Rincon,  Dr.  F.,  Maracaibo,  Venezuela. 
Semeleder,  Dr.  F.,  Mexico,  Mexico. 
Soriano,  Dr.  M.  S.,  Mexico,  Mexico. 
Strachan,  Dr.  Henry,  Kingston,  Jamaica. 

OCEANICA,     AFRICA,     AND     ASIA. 

Baelz,  Prof.  R.,  Tokyo  Japan. 
Barrett,  Dr.  Jas.  W.,  Melbourne,  Australia. 
Branfoot,  Dr.  A.  M.,  Madras,  India. 
Carageorgiades,  Dr.  J.  G.,  Limassol,  Cyprus. 
Cochran,  Dr.  Joseph  P.,  Oroomiah,  Persia. 
Coltman,  Dr.  Robert,  Jr.,  Che-foo,  China. 
Condict,  Dr.  Alice  W.,  Bombay,  India. 
Creece,  Dr.  John  M.,  Sydney,  Australia. 
Dalzell,  Dr.  J.,  Umsiga,  Natal. 
Diamantopulos,  Dr.  Geo.,  Smyrna,  Turkey. 
Drake-Brockman,  Dr.,  Madras,  India. 
Fitzgerald,  Mr.  T.  N.,  Melbourne,  Australia. 
Foreman,  Dr.  L.,  Sydney,  Australia. 
Gaidzagian.  Dr.  Ohan,  Adana,  Asia  Minor. 
Grant,  Dr.  David,  Melbourne,  Australia. 
Johnson,  Dr.  R.,  Dera  Ishmail  Khan,  Beloo- 

chistan. 
Kimura,  Prof.  J.  K.,  Tokyo,  Japan. 
Knaggs,  Dr.  S.,  Sydney,  Australia. 
Manasseh,  Dr.  Beshara  I.,  Brummana,  Turkey 

in  Asia. 
McCandless,  Dr.  H.  H.  Hainan,  China. 
Molonev,  Dr.  J.,  Melbourne,  Australia. 
Neve,  Dr.  Arthur,  Bombay,  India. 
Perez,  Dr.  George  V.,  Puerto  Orotava,  Tene- 

riffe. 
Reid,  Dr.  John,  Melbourne,  Australia. 
Robertson,  Dr.  W.  S.,  Port  Said,  Egypt. 
Rouvier,  Prof.  Jules,  Beyrouth,  Syria. 
Scranton,  Dr.  William  B.,  Seoul,  Corea. 
Sinclair,  Dr.  H.,  Sydnev,  Australia. 
Thompson.  Dr.  James  B  ,  Petchaburee,  Siam. 
Wheeler,  Dr.  P.  d'E..  Jerusalem,  Palestine. 
Whitney,  Dr.  H.  T.,  Foochow,  China. 
Whitney,  Dr.  W.  Norton,  Tokyo,  Japan. 


(29) 


Medical  Publications  of  The  F.  A.  Davis  Co.,  Philadelphia. 
■     MANNEY 

Lectures  on  Nervous  Diseases. 

From  the  Stand-Point  op  Cerebral   and   Spinal  Localization,  anb 

the  Later  Methods  Employed  in  the  Diagnosis  and 

Treatment  of  these  Affections. 

T$y  Ambrose  L.  Ranney,  A.M.,  M.D.,  Professor  of  the  Anatomy  and 
Physiology  of  the  Nervous  System  in  the  New  York  Post-Graduate 
Medical  School  and  Hospital ;  Professor  of  Nervous  and  Mental  Diseases 
in  the  Medical  Department  of  the  University  of  Vermont,  etc. ;  Author 
of  "The  Applied  Anatomy  of  the  Nervous  System,"  "  Practical  Medical 
Anatomy,"  etc.,  etc. 

It  is  now  generally  conceded  that  the  nervous  system  controls  all 
of  the  physical  functions  to  a  greater  or  less  extent,  and  also  that  most 
of  the  symptoms  encountered  at  the  bedside  can  be  explained  and 
interpreted  from  the  stand-point  of  nervous  physiology. 

Profusely  illustrated  with  original  diagrams  and  sketches  in  color 
by  the  author,  carefully  selected  wood-engravings,  and  reproduced  photo- 
graphs of  typical  cases.    One  handsome  royal  octavo  volume  of  780  pages. 

SOLD  ONLY  BY  SUBSCRIPTION,  OB  SENT  D1BECT  ON  BECEIPT  OF  PRICE, 
SHIPPING  EXPENSES  PREPAID. 

Price,  in  United  States,  Cloth,  $5.50;  Sheep,  $6.50;  Half-Russia,  $7.00. 
Canada  (duty  paid),  Cloth,  $6.05 ;  Sheep,  $7.15 ;  Half-Russia,  $7.70. 
Great  Britain,  Cloth,  32s. ;  Sheep,  37s.  61 ;  Half-Russia,  40s.  France, 
Cloth,  31  fr.  70;  Sheep,  40  fr.  15;  Half-Russia,  13  fr.  30. 


We  are  glad  to  note  that  Dr.  Ranney  has 
published  in  book  form  his  admirable  lectures 
on  nervous  diseases.  His  book  contains  over 
seven  hundred  large  pages,  and  is  profusely 
illustrated  with  original  diagrams  and  sketches 
in  colors,  and  with  many  carefully  selected 
wood-cuts  and  reproduced  photographs  of 
typical  cases.  A  large  amount  of  valuable 
information,  not  a  little  of  which  has  but 
recently  appeared  in  medical  literature,  is  pre- 


sented in  compact  form,  and  thus  made  easily 
accessible.  In  our  opinion,  Dr.  Ranney's  book 
ought  to  meet  with  a  cordial  reception  at  the 
hands  of  the  medical  profession,  for,  coen 
though  the  author's  views  may  be  sometimes 
open  to  question,  it  cannot  be  disputed  that 
his  work  bears  evidence  of  scientific  method 
and  honest  opinion. — American  Journal  of 
Insanity. 


STANTON'S 


Practical  and  Scientific  Physiognomy; 


I&3!o\3cr    to    DE^Le^a-d    Felcz&s. 

By  Mary  Olmsted  Stanton.  Copiously  illustrated.  Two  large 
Octavo  volumes. 

The  author,  Mrs.  Mary  O.  Stanton,  has  given  over  twenty  years  to 
the  preparation  of  this  work.  Her  style  is  easy,  and,  by  her  happy 
method  of  illustration  of  every  point,  the  book  reads  like  a  novel  and 
memorizes  itself.  To  physicians  the  diagnostic  information  conveyed  is 
invaluable.  To  the  general  reader  each  page  opens  a  new  train  of  ideas. 
(This  book  has  no  reference  whatever  to  phrenology.1) 

SOLD  ONLY  BY  SUBSCRIPTION,  OR  SENT  DIRECT  ON  RECEIPT  OF  PRICE, 
SHIPPING  EXPENSES  PREPAID. 

Price,  in  United  States,  Cloth,  $9.00;  Sheep,  $11.00 ;  Half-Russia,  $13.00. 
Canada  (duty  paid),  Cloth,  $10.00;  Sheep,  $12.10;  Half-Russia, 
$11.30.  Great  Britain,  Cloth,  59s. ;  Sheep,  68s. ;  Half-Russia,  80s. 
France,  Cloth,  30  fr.  30;  Sheep,  36  fr.  10;  Half-Russia,  13  fr.  30. 

(30) 


Medical  Publications  of  The  F.  A.  Davis  Co.,  Philadelphia. 


S  A  JO  US 

Lectures  on  the  Diseases  of  the  Nose 
and  Throat. 

Delivered  at  the  Jefferson  Medical  College,  Philadelphia. 

By  Charles  E.  Sajous,  M.D.,  Formerly  Lecturer  on  Rhinology  and 
Laryngology  in  Jefferson  Medical  College;  Chief  Editor  of  the  Annual  of  the 
Universal  Medical  Sciences,  etc.,  etc. 

tW  Since  the  publislier  brought  this  valuable  work  before  the  profession,  it 
has  become:  1st,  the  text-book  of  a  large  number  of  colleges ;  2d,  the  reference-book 
of  the  U.  S.  Army,  Navy,  and  the  Marine  Service ;  and,  3d,  an  important  and 
valued  addition  to  the  libraries  of  over  12,000  physicians. 

This  book  has  not  only  the  inherent  merit  of  presenting  a  clear  expose  of 
the  subject,'  but  it  is  written  with  a  view  to  enable  the  general  practitioner  to 
treat  his  cases  himself.  To  facilitate  diagnosis,  colored  plates  are  introduced, 
showing  the  appearance  of  the  different  parts  in  the  diseased  state  as  they  appear 
in  nature  by  artificial  light.  No  error  can  thus  be  made,  as  each  affection  of  the 
nose  and  throat  has  its  representative  in  the  100  chromo-lithographs  presented.  In 
the  matter  of  treatment,  the  indications  are  so  complete  that  even  the  slightest 
procedures,  folding  of  cotton  for  the  forceps,  the  use  of  the  probe,  etc.,  are 
olearly  explained. 

Illustrated  with  100  chromo-lithographs,  from  oil  paintings  by  the  author, 
and  93  engravings  on  wood.     One  handsome  royal  octavo  volume. 

80LD  ONLY  BY  SUBSCRIPTION,  OR  SENT  DIRECT  ON  RECEIPT  OF  PRICE, 
SHIPPING   EXPENSES  PREPAID. 

Price,  in  United  States,  Cloth,  Royal  Octavo,  $4.00;  Half-Russia,  Royal 
Octavo,  $5.00.  Canada  (duty  paid),  Cloth,  $140;  Half-Russia,  $5.50. 
Great  Britain,  Cloth,  22s.  6d. ;  Sheep  or  Half-Russia,  28s.  France, 
Cloth,  24  fr.  60 ;  Half-Russia,  30  fr.  30. 

It  is  intended  to  furnish  the  general  practi-  to  him  were  they  seen  in  the  living  SHbjeot. 

tioner  not  only  with  a  guide  for  the  treatment  As  a  guide  to  the  treatment  of  the  nose  and 

of  diseases  of  the  nose  and  throat,  but  also  to  throat,  we  can  cordially  recommend  this  work, 

place  before  him  a  representation  of  the  nor-  — Boston  Medical  and  Surgical  Journal. 
mal  and  diseased  parts  as  they  would  appear 


IMPORTANT  ANNOUNCEMENT.      IN  PREPARATION. 


PSYCHOPATHIA    SEXUALIS 
Sexual  Instinct. 


With   Especial   Reference  to  Contrary 


By  Dr.  It.  von  Krafft-Ebtng,  Professor  of  Psychiatry  and  Neurology 
in  the  Uuiversity  of  Vienna.  Authorized  translation  of  the  Seventh  German 
Edition  by  Charles  Gilbert  Chaddock,  M.D  ,  Assistant  Medical  Superin- 
tendent Northern  Michigan  Asylum  ;  Fellow  of  the  Chicago  Academy  of 
Medicine. 

Prof,  von  Krafft-Ebing's  study  of  the  Psychopathology  of  the  sexual  life 
was,  when  first  published,  a  small  monograph;  but  in  the  seven  editions 
through  which  it  has  passed  so  rapidly  it  has  received  so  many  additions  and 
been  made  to  cover  so  completely  every  aspect  of  the  anomalies  of  the  sexual 
sphere  tha>t  the  work  now  deserves  the  name  of  a  treatise.  It  easily  supersedes 
all  previous  attempts  to  treat  this  important  subject  scientifically,  and  it  is 
sure  to  commend  itself  to  members  of  the  medical  and  legal  professions  as  a 
scientific  explai»tion  of  many  social  and  criminal  enigmas  to  which  no  work 
in  English  offers  a  solution. 

The  work  will  be  sold  only  by  Subscription  to  Members  of  the  Medical  and 
Legal  Professions. 

(3D 


Medical  Publications  of  The  F.  A.  Davis  Co.,  Philadelphia. 

In  Press  and  in  Preparation. 


AUTO-INTOXICATION  :  Self- Poisoning  of  the  Individual. 

Being  a  series  of  lectures  on  Intestinal  and  Urinary  Pathology.  By  Prof. 
Bouchard,  Paris.  Translated  from  the  French  with  an  Original  Appendix. 
By  Thomas  Oliver,  M.D.,  Professor  of  Physiology,  University  of  Durham, 
England.     In  one  12mo  volume.     In  Press. 

DISEASES  OF  THE  LUNGS,  HEART,  AND  KIDNEYS. 

By  N.  S.  Davis,  Jr.,  A.M.,  M.D.,  Professor  of  Principles  and  Practice  of 
Medicine,  Chicago  Medical  College;  Physician  to  Mercy  Hospital,  Chicago  ; 
Member  of  the  American  Medical  Association,  etc.,  etc.  In  one  neat  12mo 
volume.  No.  in  the  Physicians'  and  Students'  Beady -Reference  Series. 
In  Press. 

TUBERCULOSIS  OF  THE  BONES  AND  JOINTS. 

By  N.  Senn,  M.D.,  Ph.D.,  Professor  of  Practice  of  Surgery  and  Clinical 
Surgery  in  Rush  Medical  College,  Chicago,  111.;  Professor  of  Surgery  in  the 
Chicago  Polyclinic  ;  Attending  Surgeon  to  the  Milwaukee  Hospital  ;  Con- 
sulting Surgeon  to  the  Milwaukee  County  Hospital  and  to  the  Milwaukee 
County  Insane  Asylum  ;  author  of  a  text-book  on  the  "Principles  of  Surgery," 
etc.,  etc.  In  one  handsome  Royal  Octavo  volume.  Illustrated  with  upwards 
of  one  hundred  (100)  engravings.     In  Press. 


A  PRACTICE  OF  SURGERY. 

By  John  H.  Packard,  A.M.,  M.D  ,  Surgeon  to  the  Pennsylvania  Hospital 
and  to  St.  Joseph's  Hospital,  Philadelphia ;  Member  of  the  American  Surgical 
Association  and  of  the  American  Medical  Association  ;  formerly  Acting 
Assistant  Surgeon  U.  S.  Army  (1861-65),  etc.,  etc.  In  one  large  Royal 
Octavo  volume.     Handsomely  illustrated.     In  Preparation. 

PRACTICAL  GYN/ECOLOGY. 

By  E.  E.  Montgomery,  A.M.,  M.D.,  Professor  of  Clinical  Gynaecology 
in  the  Jefferson  Medical  College,  Philadelphia  ;  Obstetrician  to  the  Phila- 
delphia Hospital ;  Gynaecologist  to  the  St.  Joseph  Hospital  ;  Fellow  and 
ex-President  of  the  American  Association  of'Obstetricians  and  Gynaecologists, 
etc.,  etc.  In  one  handsome  Royal  Octavo  volume.  Thoroughly  and  beauti- 
fully illustrated.     In  Preparation. 

CHILDBED:  ITS  MANAGEMENT;  DISEASES  AND  THEIR  TREAT- 
MENT. 

By  Walter  P.  Manton,  M.D.,  Visiting  Physician  to  the  Detroit  Woman's 
Hospital  :  Consulting  Gynaecologist  to  the  Eastern  Michigan  Asylum  ;  Presi- 
dent of  the  Detroit  Gynaecological  Society  ;  Fellow  of  the  American  Society 
of  Obstetricians  and  Gynaecologists  and  of  the  British  Gynaecological  Society; 
Member  of  Michigan  State  Medical  Society,  etc.  In  one  neat  12mo  volume. 
In  Preparation. 

SYPHILIS  IN  THE  MIDDLE  AGES  and  SYPHILIS  IN  MODERN  TIMES. 

Being  Volumes  II  and  III  of  a  treatise  on  "Syphilis  To-Day  and  Among 
the  Ancients."  By  Dr.  F.  Buret,  of  Paris.  Translated  from  the  French 
with  notes,  by  A.  H.  Ohmann-Dumesnil,  M.D.,  Professor  of  Dermatology 
and  Syphilology  in  the  St.  Louis  College  of  Physicians  and  Surgeons ;  Con- 
sulting Dermatologist  to  the  St.  Louis  City  Hospital;  Physician  for  Cutaneous 
Diseases  to  the-  Alexian  Brothers'  Hospital,  etc.,  etc.  "Each  volume  12mo, 
Cloth.  To  be  issued  in  the  Physicians'  and  Students'  Ready-Reference 
Series.     In  Preparation. 

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UNIVERSITY  OF  ILLINOIS-URBANA 

132.75K85PEC1892  C001 

PSYCHOPATHIA  SEXUALIS  PHILA 


3  0112 


029110449 


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